PKP治疗急性期及亚急性期椎体压缩骨折的效果分析  

The efficacy of PKP in the treatment of acute and subacute vertebral compression fractures

作　　者：马树伟[1] 吴继功[1] 马华松[1] 高博[1] MA Shu-wei;WU Ji-gong;MA Hua-song;GAO Bo(Department of Orthopedics,the 306 Hospital of PLA,Beijing 100101,China)

机构地区：[1]中国人民解放军第306医院骨科,北京100101

出　　处：《河北医科大学学报》2018年第3期280-283,共4页Journal of Hebei Medical University

摘　　要：目的探讨经皮椎体后凸成形术治疗急性期及亚急性期椎体压缩骨折的临床效果。方法回顾性分析45例经皮椎体后凸成形术治疗的骨质疏松性椎体压缩骨折患者的临床资料。A组,急性期组(受伤2周以内),23例;B组,亚急性期(受伤2周~2个月)22例。记录术前、术后视觉模拟评分法(Visual Analogue Scale,VAS)评分,X线椎体前缘、中部高度,Cobb角以及骨水泥渗漏情况。结果随访时间平均10.5个月。2组VAS评分均呈下降趋势,不同时点间差异有统计学意义(P<0.05),而组间、组间·不同时点间交互作用差异均无统计学意义(P>0.05)。B组术前、术后Cobb角均显著大于A组,且2组术后Cobb角明显大于术前(P<0.05),2组术后Cobb角恢复值差异无统计学意义(P>0.05)。B组术前和术后椎体前缘、中部椎体高度小于A组(P<0.05),A、B2组术后椎体前缘、中部椎体高度明显高于术前(P<0.05),A、B 2组术后椎体前缘、中部椎体高度恢复值差异无统计学意义(P>0.05)。A组术后复查X线发现椎体前缘骨水泥渗漏1例,椎间盘骨水泥渗漏1例,均无症状,2组患者切口均1期愈合,住院时间3~7d,随访时2组均未再出现椎体压缩骨折。结论经皮椎体后凸成形术可有效缓解骨质疏松性椎体压缩骨折患者的疼痛,亚急性期也可与急性期获得相同的椎体高度恢复及矫正后凸效果。Objective To study the clinical efficacy of percutanous kyphoplasty(PKP)in vertebral compression fractures of acute and subacute phases.Methods The clinical data of 45 patients with osteoporotic vertebral compression fractures(OVCF)receiving PKP were analyzed retrospectively,among whom 23 patients in group A,had been injured in less than 2 weeks and 22 patients in group B,had been injured in more than 2 weeks but less than 2 months.Relevant data were recorded before and after operations including Visual Analogue Scale(VAS)scores,anterior and middle vertebral heights,Cobb angles and bone cement leakage.Results The average follow-up time lasted for 10.5 months.VAS scores in two groups were in decline.Differences at points in time had statistical significance(P<0.05)There was no significant difference in the inter-group,inter-group and inter-point interaction(P>0.05).Cobb angles before and after treatments in group B were both much bigger than those of group A,either group A or group B saw a great increase in its Cobb angles after operations(P<0.05).Differences in the recovery of Cobb angles after operations for two groups showed no statistical significance(P>0.05).For group B,before operations,both anterior and middle vertebral heights were lower than those of group A(P<0.05)and the two figures for either group became higher compared with preoperative period(P<0.05).There was no significant difference in the height recovery between the anterior and central vertebral bodies in group A and group B(P>0.05).Follow-up re-examinations had found 1 case of cement leakage in anterior vertebral and 1 in intervertebral disc,with no other symptoms in group A.Hospital stays ranged from 3 to 7 days and primary healing of operative incision occurred in all patients.During our visits after surgery,no patients have had a relapse of fractures.Conclusion PKP can alleviate the pain of patients with thoracic lumbar segment OVCF effectively.Subacute patients can recover to the same level of vertebral body height and Cobb angles as acute

关 键 词：脊柱骨折 骨质疏松 椎体后凸成形术 

分 类 号：R683.2[医药卫生—骨科学]