摘要
背景:经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)在治疗骨质疏松性椎体压缩性骨折(osteoprotic vertebral compression fracture,OVCF)中能够取得非常满意的临床疗效。目的:比较分析PKP骨水泥的两种分布形态的临床疗效。方法:回顾性分析2015年1月至2015年8月行PKP治疗的OVCF患者120例。根据患者术后脊柱正侧位X线片中骨水泥分布形态,将纳入的120例患者分成A组(灌注的骨水泥在强化椎体中相互连通)79例,女51例,男28例;B组(灌注的骨水泥在强化椎体中相互分离)41例,女28例,男13例。术前、术后2 d及末次随访时采用疼痛视觉模拟量表评分(visual analogue scale,VAS)、Oswestry功能障碍指数问卷表(oswestry disability index,ODI)、伤椎前缘高度的恢复和局部后凸角(Cobb角)等评估临床疗效。采用SPSS 13.0统计分析软件对数据进行分析。结果:两组患者术后2 d和末次随访时的VAS评分、ODI评分、伤椎前缘相对高度和后凸角较术前有统计学差异(P<0.05);A组和B组术后2 d的VAS评分有统计学差异(P<0.05)。结论:相互连通和相互分离的骨水泥分布均可以实现迅速缓解胸/腰背部疼痛、恢复脊柱的生物力学稳定性、改善患者生活质量等满意的临床疗效,而相互连通的骨水泥分布具有更好的术后短期止痛效果。
Background： It is proven that percutaneous kyphoplasty（PKP） can achieve satisfied clinical efficacy for the treatment of osteoporotic vertebral compression fracture（OVCF）. Objective： To compare the clinical efficacy between two different distributions of bone cement in PKP. Methods： A total of 120 patients with OVCF treated with PKP between January 2015 and August 2015 were enrolled in this retrospective study. According to the bone cement distribution in postoperative X-ray images, they were divided into two groups. In group A（n=79, 51 females and 28 males）, infused bone cement integrated a mass in the augmented vertebrae. In group B（n=41, 28 females and 13 males）, bone cement was taken apart. Visual analogue scale（VAS）, Oswestry disability index（ODI） scores, the height and the kyphotic angle of involved vertebral bodies were measured preoperatively, on day 2 postoperatively and at the last follow-up with SPSS13.0 software. Results：The VAS scores, ODI scores, the height and kyphotic angle of involved vertebrae on day 2 postoperatively and at the last follow-up were significantly different from preoperative ones in both groups（P〈0.05）. Meanwhile, there was significant difference in VAS scores on day 2 postoperatively between two groups（P〈0.05）. Conclusions： PKP can achieve quick pain relief,function improvement and height reconstruction of involved vertebral bodies with both connected and apart distribution of bone cement. However, there is better pain relief in integrated bone cement than in apart bone cement in short-term efficacy.
出处
《中国骨与关节外科》
2017年第1期8-12,共5页
Chinese Journal of Bone and Joint Surgery
