经皮椎体后凸成形术治疗老年骨质疏松性脊柱骨折的疗效观察  

Therapeutic effect of percutaneous centrum kyphoplasty on spinal fractures in elderly patients with osteoporosis

作　　者：付士平 孙平[1] 徐苏洋[1] 高田田[1] 

机构地区：[1]上海市第八人民医院骨科,200235

出　　处：《河北医药》2015年第5期666-668,共3页Hebei Medical Journal

摘　　要：目的观察经皮椎体后凸成形术和经皮椎体成形术治疗老年骨质疏松性脊柱骨折的疗效,及其对伤残指数评定(ODI)、简明健康状态调查评分(SF-36评分)和Cobb角的影响。方法选择2010年1月至2013年12月就诊的骨质疏松性胸腰椎压缩性骨折患者90例,随机分为观察组和对照组,每组45例。对照组给予经皮椎体成形术,观察组给予皮椎体后凸成形术。观察2组疗效、手术时间、术中出血量、术后伤椎增加高度、骨水泥的注入量和骨水泥的渗漏率,以及治疗前后SF-36、ODI和Cobb角的变化。结果观察组总有效率为91.11%,对照组为84.44%,2组的总有效率差异无统计学意义(χ2=0.414,P>0.05)。观察组的手术时间、术后伤椎增加高度、骨水泥注入量均较对照组变长或者增加(P<0.01),而与对照组比较骨水泥渗漏率明显降低(P<0.05),术中出血量2组差异无统计学意义(P>0.05)。2组治疗后SF-36较治疗前增加(P<0.01),而ODI和Cobb角较治疗前明显降低(P<0.01),观察组的增高或者降低水平更为明显(P<0.01)。结论经皮椎体后凸成形术治疗骨质疏松性脊柱骨折疗效显著,具有创伤小,并发症少,有利于老年骨质疏松性脊柱骨折患者的康复,值得临床推广应用。Objective To observe the therapeutic effect of percutaneous centrum kyphoplasty and percutaneous vertebroplasty on spinal fractures in elderly patients with osteoporosis, and to evaluate its influence on Oswestry disability index （ODI） , condensed survey rated health status （SF-36 score ） and Cobb angle. Methods Ninety patients with osteoporotic spinal fracture, admitted into our hospital from January 2010 to December 2013 ,were randomly divided into observation group and control group, with 45 patients in each group. The patients in control group received pereutaneous vertebroplasty, however, the patients in observation group received percutaneous centrum kyphoplasty. The therapeutic effects after operation, operative time, hemorrhage volume during operation, postoperative vertebral height, the amount of bone cement ,leakage rate of cement were observed, moreover, the changes of levels of SF-36, ODI and Cobb angle were also observed before and after treatment for both groups. Results The total effective rate was 91.11% and g4.44% ,respectively in observation group and control group, there was no significant difference between two groups （X2 = 0. 414, P 〉 0.05 ）. The operative time, postoperative vertebral height, the amount of bone cement in observation group were increased, as compared with those in control group （ P 〈 0.01 ）, however,the cement leakage rate was significantly decreased in observation group （ P 〈 0.05）. There was no significant difference in the hemorrhage volume during operation between two groups （ P 〉 0. 05 ）. The levels of SF-36 and Cobb angle after treatment in control group were obviously increased, as compared with those before treatment （ P 〈 0. 01 ） , but ODI after treatment was significantly lower than that before treatment （ P 〈 0.01 ）, moreover, the increasing or decreasing levels in observation group were more obvious than those in control group （ P 〈 0. 01 ）. Conclusion The therapeutic effect of percutaneous centrum kyphoplasty is s

关 键 词：骨质疏松 脊柱骨折 椎体后凸成形术 治疗结果 

分 类 号：R274.1[医药卫生—中医骨伤科学]