不同时间骨质疏松性椎体压缩骨折的经皮椎体成形治疗  

Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures with different fracture periods

作　　者：张其亮[1] 王峻 林勇[1] 

机构地区：[1]青岛市市立医院(东院区)骨科,山东省青岛市2660712 [2]莱阳市中心医院骨科,山东省莱阳市265220

出　　处：《中国组织工程研究》2013年第21期3831-3838,共8页Chinese Journal of Tissue Engineering Research

摘　　要：背景:近年来应用经皮椎体成形治疗老年骨质疏松性椎体压缩骨折的技术正在逐步开展,但其治疗不同骨折时间患者的疗效还存在争议。目的:对比经皮椎体成形治疗不同骨折时间骨质疏松性椎体压缩骨折的临床疗效。方法:回顾性分析随访资料完整的行经皮椎体成形治疗的骨质疏松性椎体压缩骨折病例91例(127节椎体)。按照受伤或疼痛发生到手术时间将病例分为3组:伤后3周内组、伤后3周-6个月组、伤后6个月以上组,比较3组经皮椎体成形治疗后疼痛缓解、日常生活能力恢复及椎体高度恢复情况。结果与结论:①3组治疗后疼痛明显缓解,且随着时间的延长疼痛逐渐减轻(P<0.01)。伤后3周内组与伤后3周-6个月组治疗后不同时间点疼痛缓解情况明显优于伤后6个月以上组(P<0.01),前两组组间比较差异无显著性意义。②3组治疗后日常生活能力评分明显提高,且随时间延长逐步提高(P<0.01)。不同时间点组间比较:伤后3周内组>伤后3周-6个月组>伤后6个月以上组(P<0.01)。③治疗前椎体前缘及中间高度比较,3组未见明显差别;治疗后3d椎体前缘及中间高度比较,伤后3周内组>伤后3周-6个月组>伤后6个月以上组(P<0.01)。治疗前及治疗后3d各组椎体后缘高度差异无显著性意义。表明经皮椎体成形治疗对于伤后6个月以上陈旧性骨折的疗效较差。BACKGROUND: In recent years, the technique of percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures is gradual y developed, but there is a controversy of the clinical effectiveness of percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures with different fracture periods. OBJECTIVE: To compare the effectiveness of percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures with different fracture periods METHODS: A retrospective study was conducted to review 91 cases receiving percutaneous vertebroplasty on 127 vertebral compression fractures. The patients were divided into three groups according to the time from fracture or pain occurrence to surgery: < 3 weeks group, 3 weeks-6 months group, ≥ 6 months group. The visual analogue scale, the Activity of Daily Living Scale and the height of vertebras were recorded and analyzed in the three groups. RESULTS AND CONCLUSION: (1) Pain was relieved significantly in the three groups with time going (P < 0.01). The pain relief was superior in the < 3 weeks group and 3 weeks-6 months group as compared with ≥ 6 months group (P < 0.01), but there was no difference between the former two groups. (2) Scores on the Activity of Daily Living Scale were al increased in the three groups after treatment, and gradual y increased with time going (P < 0.01). The scores in the three groups were ranked from top to bottom as fol ows: < 3 weeks group, 3 weeks- 6 months group, and ≥ 6 months group (P < 0.01). (3) No difference in anterior and middle vertebral height was found among the three groups before treatment. At 3 days after treatment, the anterior and middle vertebral height was arranged from top to bottom as fol ows: 3 weeks group, 3 weeks-6 months group, and ≥ 6 months group (P < 0.01). There was no difference in the posterior vertebral height among three groups prior to treatment and at 3 days after treatment. Results show that the clinical effectiveness of percu

关 键 词：生物材料 组织工程骨材料 经皮椎体成形 骨水泥 骨质疏松性椎体压缩骨折 疼痛 日常生活能力 椎体前缘 椎体高度 

分 类 号：R318[医药卫生—生物医学工程]