老年胸腰椎压缩性骨折治疗方案及可行性分析  

Treatment options and feasibility analysis of thoracolumbar vertebral compression fractures in the elderly

作　　者：李永新[1] 尹利荣 刘永权 李嘉麒 李燕莉[1] 牛增广[1] LI Yongxin;YIN Lirong;LIU Yongquan;LI Jiaqi;LI Yanli;NIU Zengguang(Department of Orthopedics,the First Hospital of Qinhuangdao City of Hebei Province,Qinhuangdao,Hebei,066001;Department of Imaging,the First Hospital of Qinhuangdao City of Hebei Province,Qinhuangdao,Hebei,066001)

机构地区：[1]河北省秦皇岛市第一医院骨科,河北秦皇岛066001 [2]河北省秦皇岛市第一医院影像科,河北秦皇岛066001

出　　处：《实用临床医药杂志》2024年第5期94-98,共5页Journal of Clinical Medicine in Practice

基　　金：2020年度河北医学科研课题计划项目(202013111)。

摘　　要：目的探讨不同治疗方案对老年胸腰椎压缩性骨折患者腰椎功能、疼痛程度、椎体前缘高度的影响。方法回顾性分析完成1年随访的102例老年胸腰椎压缩性骨折患者的临床资料,依据治疗方案的不同分为保守组(32例)、经皮球囊扩张椎体后凸成形术(PKP)组(35例)、经皮椎体成形术(PVP)组(35例),治疗1年后评估3组临床疗效和并发症发生情况,比较3组治疗前和治疗1年后视觉模拟评分法(VAS)评分、日本骨科学会(JOA)评分、Cobb角、椎体前缘高度。结果PKP组、PVP组治疗优良率高于保守组,差异有统计学意义(P<0.05);PKP组与PVP组治疗优良率比较,差异无统计学意义(P>0.05)。3组并发症发生率比较,差异无统计学意义(P>0.05)。治疗1年,3组VAS评分低于治疗前,JOA评分高于治疗前,且PKP组、PVP组VAS评分低于保守组,JOA评分高于保守组,差异有统计学意义(P<0.05);PKP组VAS评分低于PVP组,JOA评分高于PVP组,差异有统计学意义(P<0.05)。治疗1年,3组Cobb角小于治疗前,椎体前缘高度高于治疗前,其中PKP组、PVP组Cobb角小于保守组,椎体前缘高度高于保守组,差异有统计学意义(P<0.05);PKP组Cobb角小于PVP组,椎体前缘高度高于PVP组,椎体前缘高度差值大于PVP组,差异有统计学意义(P<0.05)。结论与保守治疗相比,手术可提高老年胸腰椎压缩性骨折患者的临床疗效。PKP在减轻患者疼痛程度、提高腰椎功能、改善Cobb角、椎体前缘高度方面优于PVP,且安全性较好。Objective To investigate the impact of different treatment options on lumbar function,pain intensity,and anterior vertebral height in elderly patients with thoracolumbar vertebral compression fractures.Methods The clinical data of 102 elderly patients with thoracolumbar vertebral compression fractures who completed 1-year follow-up were retrospectively analyzed.They were divided into conservative group(32 cases),percutaneous kyphoplasty(PKP)group(35 cases),and percutaneous vertebroplasty(PVP)group(35 cases)based on different treatment options.One year after treatment,the clinical efficacy and complications of the three groups were evaluated.The Visual Analogue Scale(VAS)score,Japanese Orthopedic Association(JOA)score,Cobb angle,and anterior vertebral height were compared before and 1 year after treatment among the three groups.Results The excellent and good rates of the PKP group and PVP group were higher than those of the conservative group(P<0.05).There was no significant difference in the excellent and good rates between the PKP group and PVP group(P>0.05).There was no significant difference in occurrence of complications among the three groups(P>0.05).One year after treatment,the VAS scores of the three groups were lower than before treatment,and the JOA scores were higher than before treatment,and the VAS scores of the PKP group and PVP group were lower than those of the conservative group,and the JOA scores were higher than those of the conservative group(P<0.05).The VAS score of the PKP group was lower than that of the PVP group,and the JOA score was higher than that of the PVP group(P<0.05).One year after treatment,the Cobb angles of the three groups were smaller than before treatment,and the anterior vertebral heights were higher than before treatment,and the Cobb angles of the PKP group and PVP group were smaller than those of the conservative group,and the anterior vertebral heights were higher than those of the conservative group(P<0.05).The Cobb angle of the PKP group was smaller than that of the PVP

关 键 词：胸腰椎压缩性骨折 老年人 经皮球囊扩张椎体后凸成形术 经皮椎体成形术 

分 类 号：R683[医药卫生—骨科学] R274.13[医药卫生—外科学] R61[医药卫生—临床医学]