经皮椎体成形术与非手术治疗对老年创伤性胸腰椎单椎体轻度压缩性骨折的疗效对比研究  

A comparative study of percutaneous vertebroplasty and conservative therapy for the elderly patients with light single thoracolumbar vertebral compression fracture caused by trauma

作　　者：范亚一[1] 马蓓[2] 李伟伟[1] 周永春 刘军[1] 弓立群[1] FAN Ya-yi;MA Bei;LI Wei-wei;ZHOU Yong-chun;LIU Jun;GONG Li-qun(Department of Orthopedics,Shaanxi Provincial People's Hospital,Xi'an 710068,China;Operation Center,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院骨科,西安710068 [2]陕西省人民医院手术室,西安710068

出　　处：《创伤外科杂志》2020年第1期14-17,共4页Journal of Traumatic Surgery

基　　金：西安市科技计划[2017115SF/YX009(3)]

摘　　要：目的比较经皮椎体成形术(PVP)与非手术治疗对老年创伤性胸腰椎单椎体轻度压缩性骨折的临床效果。方法回顾性分析2011年1月—2015年12月收治的因创伤所致的单个胸腰椎轻度压缩性骨折患者128例,男性46例,女性82例;年龄60~83岁,平均69.8岁。根据治疗方法不同分为PVP治疗组和非手术治疗组。比较两组伤后1年VAS评分、Oswestry功能障碍指数(ODI指数)及SF-12评分。结果128例均获随访,随访时间12~34个月,平均16.8个月。两组的性别构成比、年龄、身体质量指数、骨折压缩程度及骨密度比较差异均无统计学意义(P>0.05),具有可比性。伤后1年,PVP组的VAS评分、ODI指数、SF-12躯体评分及SF-12心理评分分别为(1.9±0.8)分、(35.7±4.4)%、(70.5±7.4)分和(75.1±5.4)分,非手术治疗组分别为(1.7±0.6)分、(31.5±3.3)%、(76.6±9.2)分和(79.0±6.7)分;两组VAS评分比较差异无统计学意义(P>0.05),但非手术治疗组的ODI指数低于PVP治疗组,SF-12评分高于PVP治疗组(P<0.05)。结论对创伤性老年胸腰椎单椎体轻度压缩性骨折而言,与非手术治疗相比,PVP对伤后1年后的腰痛缓解并无帮助,且可能会导致患者的腰椎功能及生活质量下降。Objective To compare the clinical effects of percutaneous vertebroplasty(PVP)and conservative treatment for light single thoracolumbar compression fracture of the elderly caused by trauma.Methods Data of 128 elderly patients with light single thoracolumbar vertebral compression fracture caused by trauma was retrospectively analyzed,who were admitted in our hospital from Jan.2011 to Dec.2015.There were 46 males and 82 females,with an average age of 69.8 years(range,60-83 years).All cases were divided into PVP treatment group and conservative therapy group.VAS,ODI and Short Form(SF)-12 scores were compared between the two groups one year after injury.Results All patients were followed up for 12-34(mean,16.8)months.No statistically significant difference was observed between the two groups in gender ratio,age,body mass index,fracture compression severity or bone density(P>0.05).The VAS,ODI and SF-12 scores(including physical and psychological score)in the PVP treatment group were(1.9±0.8)points,(35.7±4.4)%,(70.5±7.4)points and(75.1±5.4)points,respectively;the VAS,ODI and SF-12 scores in the conservative treatment group were(1.7±0.6)points,(31.5±3.3)%,(76.6±9.2)points and(79.0±6.7)points,respectively.The difference of VAS score between the two groups was not statistically significant(P>0.05),but ODI was lower and SF-12 scores in conservative therapy group were significant higher than those of the PVP treatment group(P<0.05).Conclusion Compared to the conservative treatment,PVP treatment has no advantage in pain relief at one year after injury for the elderly patients with light single thoracolumbar compression fracture caused by trauma,and may result in exacerbation of lumbar spine function disability and decline of life quality.

关 键 词：胸腰椎压缩性骨折 经皮椎体成形术 非手术 疗效 

分 类 号：R687.3[医药卫生—骨科学]