椎体成形术与保守方法治疗椎体骨折的对照研究  

Percutaneous vertebroplasty and conservative management for the treatment of osteoporotic vertebral fractures:a comparative study

作　　者：刘文贵[1] 吕锦瑜[2] 孙建华[3] 梁定[1] 李志伟[2] 王和生[3] 郭山峰[1] 

机构地区：[1]江苏省中医院放射介入科,南京210029 [2]江苏省中医院骨科,南京210029 [3]江苏省中医院针灸康复科,南京210029

出　　处：《介入放射学杂志》2011年第9期733-736,共4页Journal of Interventional Radiology

基　　金：江苏省中医药局科技项目(LB09043)

摘　　要：目的通过经皮椎体成形术(PVP)与保守方法治疗骨质疏松性椎体压缩骨折(OVCF)的初步对照研究结果,探讨OVCF的更有效治疗措施。方法自2009年12月至2010年12月以相同的研究标准对来院接受PVP或保守治疗的OVCF患者进行前瞻性分组研究,以疼痛视觉模拟评分(VAS)及Oswestry功能障碍指数(ODI)问卷分别对患者治疗前,治疗后1周,1、3、6个月及1年时的状况进行评分,并随访患者治疗后的活动水平、并发症等其他信息。结果共有22例PVP和21例保守治疗患者入组,术前两组间的VAS、ODI评分差异均无统计学意义(P>0.05);治疗后1周,1、3个月的组间VAS、ODI评分及随访的活动水平数据均显示差异有统计学意义(P<0.05);保守组出现1例再发骨折。结论与保守治疗方法相比,PVP治疗OVCF优势明显,应作为首选的治疗手段。Objective To investigate the better therapeutic measures for painful osteoporotic vertebral compression fractures（OVCF） through comparing the efficacy of percutaneous vertebroplasty（PVP） with that of conservative management.Methods Forty-three consecutive patients,encountered from December 2009 to December 2010 in authors＇ hospital,were enrolled in this study.The patients were divided into PVP group（n = 22） and conservative group（n = 21）.Visual analog score（VAS） for pain and Oswestry disability index（ODI） questionnaire scores were assessed before and 1 week,1,3,6,12 months after the treatment.Patients＇ activity levels and other information,including complications and new fractures after treatment,were also evaluated.Results Before the treatment both the VAS and ODI scores showed no statistically significant difference between the two groups.Significant reduction of both VAS and ODI was observed in PVP group at 1 week and at 1 and 3 months after the treatment when compared with those in conservative group（P〈0.05）.Patients＇ activity levels in PVP group were significantly improved than that in conservative group（P〈0.01）.One new fracture was observed in the conservative group,while no new fracture was seen in the PVP group.Conclusion Immediate pain relief and improvement of daily activities after PVP can be achieved in all patients.PVP should be considered as the treatment of first choice for symptomatic osteoporotic vertebral fractures.

关 键 词：经皮椎体成形术 保守治疗 椎体骨折 骨质疏松 对照研究 

分 类 号：R687.3[医药卫生—骨科学]