单纯PKP治疗老年骨质疏松性胸腰段压缩性骨折的临床疗效  

The Simple PKP Treatment of Osteoporotic Thoracolumbar Compression Fractures

作　　者：曹众 孟庆奇 CAO Zhong;MENG Qing-qi(Kanghua Hospital of Dongguan, Guangdong Province, 523000;Red Cross Hospital of Guangzhou)

机构地区：[1]广东省东莞市康华医院,523000 [2]广州市红十字会医院

出　　处：《岭南急诊医学杂志》2018年第3期272-274,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:比较经皮椎体后凸成形术(PKP)、经皮椎体成形术(PVP)和传统切开复位椎弓根钉内固定术治疗老年骨质疏松伴胸腰段椎体压缩性骨折的临床疗效。方法:回顾性分析广东省东莞市康华医院和广州市红十字会医院2013年1月至2015年1月间收治的老年骨质疏松并胸腰段椎体压缩性骨折(T12-L2)患者150例的临床资料,分为PKP组、PVP组和对照组,每组各50例,分别采用PKP治疗、PVP治疗和腰椎后路切开复位椎弓根钉内固定术治疗,术后常规对症治疗,并随访3年,比较三组手术时间、术中出血量、术中透视次数、住院费用、并发症发生情况、手术前后疼痛评分、椎体前缘高度、Cobb角和相邻节段骨折情况。结果:PKP组手术费用最高,对照组术中出血量、手术时间及术中透视次数明显高于其他两组(P均<0.05);PKP组、PVP组术后VAS评分明显优于对照组;而随访1年后对照组椎体前缘高度、Cobb角较其他两组明显丢失(P<0.05);随访2年、3年后PKP组、PVP组的Cobb角均显著优于对照组(P<0.001)。结论:PKP和PVP治疗老年骨质疏松性胸腰段压缩性骨折疗效优于传统切开手术,而PKP在并发症和再骨折发生率上均优于PVP。Objective：To observe the effects of pereutaneous kyphoplasty （PKP） and percutaneous vertebroplasty （PVP） and traditional open reduction and pediele screw fixation in the treatment of senile osteoporosis with thoracolumbar vertebral body compression fractures in clinical efficacy. Methods： A retrospective analysis of 150 elderly patients with thoracolumbar vertebral compression fracture （T12-L2） associated with osteoporosis admitted to the two hospitals from Jan 2013 to Jan 2015 were divided into PKP group, PVP group and control group, each group were 50 cases, treated by PKP, PVP and lumbar posterior open reduction and pedicle screw fixation prespectively. All the cases were treated by routine postoperative symptomatic and were followed up for 3 years. The operative time, bleeding volume, intraoperative fluoroscopy times and the cost of hospitalization, the complication, pain scores before and after surgery, anterior vertebral height, Cobb angle and adjacent segment fracture were compared among three groups. Results： The cost in PKP group was significantly higher than that in the other two groups （both P〈0.05）. The bleeding and operation period and intraoperative fluoroscopy times in the control group were signifieant more than those in the other two groups （all P〈0.05）. Postoperative VAS score in PKP group and PVP group were better than those in the control group （both P〈0.05）. After 1 years of follow-up, anterior vertebral body height, Cobb angle loss in the control group were significant difference than those in the other two groups （P〈0.05）. After 2 and 3 years of follow-up, Cobb angle in PKP group and PVP group were significant better than those in the control group （P〈0.05）. Conclusion： It is better that elderly patient with osteoporotie thoracolumbar fracture treated by PKP and PVP compared with traditional open surgery, and PKP in complications and re-fracture rate is better than PVP.

关 键 词：胸腰段压缩性骨折 经皮椎体成形术 切开复位内固定 经皮椎体后凸成形术 

分 类 号：R687.3[医药卫生—骨科学]