椎体内裂隙位置对PVP手术疗效的影响  

Influence of the fracture position in the vertebral body on the effect of PVP operation

作　　者：林岿然 LIN Kui-ran(Second Department of Orthopadics,First People＇s Hospital of Pingdingshan,Henan,467000,China)

机构地区：[1]河南省平顶山市第一人民医院骨外二科,河南平顶山467000

出　　处：《颈腰痛杂志》2018年第5期617-619,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨PVP手术治疗陈旧性骨质疏松性椎体压缩骨折(osteoporotic vertebralcompression fractures,OVCF)过程中,椎体内真空裂隙(Intravertebral Vacuum Cleft,IVC)位置对其疗效的影响。方法回顾性分析2012-07-2015-07行PVP手术治疗的73例陈旧性OVCF患者临床资料(均伴有IVC特征),依据IVC在伤椎内的位置,将其分为三组:A组32例,IVC靠近上终板;B组24例,IVC靠近下终板;C组17例,IVC靠近上、下终板。对三组患者术前、术后3 d和2年时的相关指标进行对比。结果术后3 d时,三组患者VAS评分和ODI指数均有显著下降(P<0.05),伤椎相对高度和后凸Cobb角亦得到明显矫正(P<0.05)。但术后2年时,三组患者VAS评分和ODI指数均有一定程度的升高(P<0.05),伤椎相对高度和后凸Cobb角亦有明显的矫正度丢失现象,且以B组为甚,其次是A组,C组最轻微,组间差异有统计学意义(P<0.05)。结论伤椎内IVC位置对PVP手术存在明显影响,IVC偏下者在后期易出现明显的伤椎矫正度丢失现象,偏上者次之,IVC同时接近上、下终板者的后期结局最佳。Objective To investigate the influence of vacuum fracture （IVC） position on the effi-cacy of PVP in the treatment of old osteoporotic vertebral compression fractures （OVCF）. MethodsFrom July 2012 to July 2015, the clinical data of 73 cases with OVCF （with IVC） who received PVPfor surgical treatment were retrospectively analyzed. According to the IVC position in vertebral, thepatients were divided into three groups： 32 cases in group A, IVC near the upper endplate; 24 cases ingroup B, IVC near the lower endplate; 17 cases in group C, IVC near the upper and lower endplate.The related indicators were compared among the three groups before operation and 3d, 2 years afteroperation. Results At 3d after operation, the VAS score and ODI index of the three groups were sig-nificantly decreased （P〈0.05）, and the relative height of the injured vertebrae and the kyphosis Cobbangle were also corrected significantly （P〈0.05）. But after 2 years, the VAS score and ODI index in thethree groups were increased to a certain extent （P〈0.05）, the relative vertebral height and kyphosisCobb angle had obvious loss of correction, and those were significant in group B, followed by A group,those in C group were slight, there were statistically significant differences among three groups （P〈0.05）. Conclusion The IVC position in the vertebra body has a significant impact on the operation ofPVP, IVC with partial in the late prone to obvious vertebral correction loss phenomenon, partial persontimes, IVC at the same time close to the upper and lower endplate the late outcome best.

关 键 词：陈旧性骨折 骨质疏松性椎体压缩骨折 椎体内真空裂隙 PVP手术 矫正度丢失 

分 类 号：R589[医药卫生—内分泌]