经皮椎体后凸成形术与非手术治疗急性和亚急性骨质疏松性椎体压缩性骨折临床研究

目的 经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)与非手术疗法治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCF),探讨其有效性和安全性仍然不明朗.方法 164例骨质疏松性脊柱骨折患者被纳入前瞻性随机对照研究...

Clinical study of acute and subacute osteoporotic vertebral compression fractures with percutaneous kyphoplasty and conservative treatment

Objective To compare the efficiency and safety of percutaneous kyphoplasty(PKP) and conservative treatment in treating osteoporotic vertebral compression fractures.Methods There were 164 patients with osteoporotic vertebral compression fractures.Acute patients whose osteoporotic fractures occurred within 2 weeks and sub-acute patients within 2 to 8 weeks were randomly divided into the conservative treatment group and PKP group.Improvement of symptoms,vertebral height restoration rate,correction rate of kyphosis,bone cement leakage,pain,physical and psychological results were observed.Visual analog scale was applied to assess the degree of pain;SF-36 form and the Dallas questionnaire were used to evaluate the physiological and psychological changes.Results In the PKP group,there were 77 cases,including 47 males and 30 females,aging 57-77 years(average 67 years);while in the conservative treatment group,there were 87 cases,including 43 males and 44 females,aging 60-82 years(average 67 years).The initial and 3 month follow-up showed a considerable degree of pain relief in both groups from Jul.2007 to Jul.2010(P<0.05).Visual analog scale decreased from 7.70 to 1.80,indicating significant difference(P<0.05).Pain relief was remarkable within 12-24 hours after surgery in PKP group(P<0.05).The preoperative VAS pain score was 7.70±1.00,compared with VAS score of 1.80±0.91 at 24 hours after operation(P<0.05).The average anterior vertebral body height restored by 27.90%(P<0.05).The average correction rate of vertebral kyphosis was 12.60 °(P<0.05).Conclusion Osteoporotic vertebral compression fracture could rapidly acquire pain release,restore height of vertebral body and improve abnormality by means of PKP.