经皮椎体成形术和后凸成形术治疗老年骨质疏松性椎体爆裂骨折的对比研究  

Comparison of curative effect of PVP vs. PKP in treatment of osteoporotic vertebral burst fracture in senile patients

作　　者：郭振鹏[1] 尚晖[1] 黄润强[2] 李兵奎[1] 邓磊[1] 杨棋[1] 

机构地区：[1]十堰市太和医院(湖北医药学院附属医院)骨3科,湖北十堰442000 [2]十堰市太和医院(湖北医药学院附属医院)妇科,湖北十堰442000

出　　处：《骨科》2016年第3期159-163,共5页ORTHOPAEDICS

基　　金：湖北省自然科学基金(W2014ZT292)

摘　　要：目的探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)和经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗老年骨质疏松性椎体爆裂骨折(osteoporotic vertebral burst fracture,OVBF)的临床疗效及安全性。方法回顾性分析2008年2月至2015年2月我院收治的63例单节段老年OVBF患者的临床资料,按照治疗方法分为PVP组(37例)和PKP组(26例),对比两组患者的手术时间、住院时间、骨水泥注入量、骨水泥渗漏率、住院费用及手术前后的疼痛视觉模拟量表(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)、后凸Cobb角、椎体前缘及中央高度、椎管占位程度以及SF-36量表评分。结果 PVP组在手术时间、骨水泥注入量及住院费用方面明显低于PKP组,差异均具有统计学意义(均P<0.05)。PVP组和PKP组的骨水泥渗漏率分别为10.8%、3.8%,差异具有统计学意义(χ2=4.212,P=0.034)。两组患者术后及末次随访时的各项指标均较术前有明显改善;PKP组患者术后及末次随访时的椎体前缘和中间高度、后凸Cobb角及椎管占位程度的改善显著优于PVP组,差异均具有统计学意义(均P<0.05)。结论采用PVP和PKP治疗椎管占位程度小于20%且无神经症状的老年OVBF安全可行,各有优势,应根据具体情况选择。Objective To compare the curative effect of the percutaneous vertebroplasty（PVP） vs. per-cutaneous kyphoplasty（PKP） in treatment of osteoporotic vertebral burst fracture（OVBF）. Methods Retro-spective analysis on 63 senile patients with single segmental OVBF from February 2008 to February 2015 wasdone. The patients were divided into PVP group（37 cases） and PKP group（26 cases） according to the differentsurgical methods. Operation time, bone cement injection volume, length of hospital stay, hospital expenses andbone cement leakage rate, the visual analogue scale（VAS）, Oswestry disability index（ODI）, vertebral height, ky-photic Cobb angle, and degree of vertebral canal placeholder were compared between the two groups. SF- 36 questionnaire was used to evaluate the quality of life of the patients. Results The operation time was shorter,bone cement injection volume was less and hospital expenses were significantly lower in PVP group than inPKP group（P〈0.05 for all）. The bone cement leakage rate in PVP group and PKP group respectively was 10.8%and 3.8%, with the difference being statistically significant（χ2=4.212, P=0.034）. All the items were obviouslyimproved in both two groups. The improvements in kyphotic Cobb angle, vertebral height, and degree of verte-bral canal placeholder in PKP group after the surgery and at the time of the last follow-up were better than inPVP group（P〈0.05）. Conclusion PVP and PKP in treatment of the senile osteoporotic vertebral burst fracture（spinal canal placeholder is less than 20% and no neurologic symptoms） were safety and feasibility. PVP andPKP have their own advantages, and can be chosen according to specific situations.

关 键 词：骨质疏松 脊柱骨折 经皮椎体成形术 经皮椎体后凸成形术 

分 类 号：R687.3[医药卫生—骨科学] R580[医药卫生—外科学]