摘要
目的比较单、双侧椎体后凸成型术（PKP）对老年骨质疏松性椎体压缩骨折（OVCF）的临床疗效,以期为手术策略的选择提供理论依据。方法将2012年1月~2014年12月我院就诊的78例老年OVCF患者纳入研究,按照随机数字表分为对照组（39例）和观察组（39例）,分别接受单、双侧PKP治疗。比较两组患者手术时间、术中出血量、术后及中远期疼痛视觉模拟评分系统（VAS）评分,椎体前缘、中柱和后缘的高度恢复值、Cobb角等指标。结果对照组患者手术时间、术中出血量、术中透视次数、骨水泥注入量和住院费用方面优势较为明显,差异有统计学意义（P〈0.05）。两组患者经PKP后椎体前缘和中间部位高度均有明显改善,但两组间差异均无统计学意义（均P〉0.05）。VAS方面,对照组术后和随访中疼痛缓解情况较观察组优势明显,差异均有统计学意义（均P〈0.05）。Cobb角方面,两组患者术前、术后和末次随访时Cobb角并未显示出明显区别,差异均无统计学意义（均P〉0.05）。结论单、双侧PKP均能有效恢复脊柱形态、抑制疼痛,单侧入路手术时间短、术中出血量少,值得临床广泛推广。
Objective To compare clinical efficacy of unilateral and bilateral perutaneous kyphoplasty（PKP） for elderly patients with osteoporotic vertebral compression fractures（OVCF）,in order to provide a theoretical basis for the choice of surgical strategy.Methods 78 elderly patients who suffered OVCF were included into the research from January 2012 to December 2014.All cases were randomly divided into control group（n=39 cases） and observation group（n=39 cases）and received unilateral and bilateral PKP.Parameters including operative time,intraoperative blood loss,postoperative and mid-long-term visual analog pain scoring system（VAS） score,the height recovery value of in fanterior edge,middle edge and trailing edge,Cobb angle etc. were compared between two groups.Results There were significant differences between two groups about operative time,intraoperative blood loss,intraoperative fluoroscopy times,the amount of bone cement,hospital costs（all P〈0.05）.The vertebral height of fanterior and middle edge of two groups were improved after operation,but there was no significant difference between two groups（all P〈0.05）.For VAS and pain relief were improved significantly than those before operation,there were significant differences between two groups（all P〈0.05）.Compared to preoperative that,postoperative Cobb angle and final follow-up did not show a significant difference（all P〈0.05）.Conclusion Unilateral and bilateral PKP can effectively restore spine morphology and suppress pain,unilateral approach can shorten operative time,reduce intraoperatve blood loss,and is worthy of wider promotion.
出处
《中国当代医药》
2016年第25期81-84,共4页
China Modern Medicine
关键词
骨质疏松性椎体骨折
单侧入路
双侧入路
椎体后凸成型术
Osteoporotic vertebral fractures
Unilateral approach
Bilateral approach
Percutaneous kyphoplasty
