海南医科大学学报

目的:探讨椎体后凸成形术(PKP)治疗老年骨质疏松性椎体压缩性骨折的临床疗效及安全性。方法:将65例(91椎)老年骨质疏松性椎体压缩性骨折患者随机分为观察组和对照组,观察组采用PKP治疗,对照组采用经皮椎体成形术(PVP)治疗,比较两组患者术前、术后疼痛视觉模拟评分(VAS)、椎体前中柱平均高度、Oswestry功能评分、后凸畸形矫正情况及骨水泥渗漏发生情况。结果:两组术后VAS均较术前明显降低(P<0.05),而术后两组VAS、椎体前中柱平均高度及Cobb角比较差异无统计学意义(P>0.05);观察组骨水泥渗漏发生率显著低于对照组,差异有统计学意义(P<0.05);两组患者术后Oswestry功能评分均较术前显著降低(P<0.05),但术后两组患者Oswestry功能评分比较差异无统计学意义(P>0.05)。结论:PKP能显著减少骨水泥渗漏的发生,但费用较高;PVP费用低,操作简单,但骨水泥渗漏率较高。两种方法治疗老年骨质疏松性椎体压缩性骨折疗效相当,均能有效缓解椎体压缩性骨折引起的疼痛,改善患者脊柱功能。

Objective:To explore the clinical effect and safety of percutaneous kyphoplasty(PKP)in the treatment of senile osteoporotic vertebral compression fractures.Methods:Sixty-five old patients(91vertebrae)with osteoporotic vertebral compression fractures were randomly divided into observation group and control group.The patients in observation group were treated with PKP,while those in control group with percutaneous vertebroplasty(PVP).The visual analogue scale(VAS)of pain,mean anterior-middle vertebral spinal height,Oswestry function score,and conditions of kyphosis correction and occurrence of cement leakage before and after operation were compared in two groups.Results:Postoperative VAS of patients in two groups obviously decreased compared with operation before(P<0.05),but there were no significant differences in postoperative VAS,mean anterior-middle vertebral spinal height and Cobb angle(P<0.05);the incidence of cement leakage in observation group was markedly lower than control group,the difference had statistical significance(P<0.05);Postoperative Oswestry functional score of patients in two groups obviously decreased compared with operation before,but there were no significant differences(P<0.05).Conclusion:PKP can effectively decrease the occurrence of cement leakage,but the cost is high;PVP has low cost and simple performance,but the incidence of cement leakage is high.The therapeutic effects of PKP and PVP are similar for treating senile osteoporotic vertebral compression fractures,and both can effectively alleviate the pain induced by vertebral compression fractures and improve the function of spinal cord.