经皮椎体成形、后凸成形和Sky成形术的中期疗效分析

目的评价经皮椎体成形、后凸成形和膨胀式椎体成形器(Sky)成形术治疗老年骨质疏松椎体压缩性骨折的中期临床疗效。方法回顾性分析2002年1月～2004年6月我院开展的经皮椎体成形术14例、后凸成形术8例和Sky成形术6例治疗老年骨质疏松椎体压缩性骨折的临床资料,比较手术前后及手术后1年、5年椎体后凸畸形Cobb角及疼痛缓解效果的变化。结果所有患者均无临床并发症;经皮椎体成形术在椎体后凸畸形Cobb角矫正方面差于后凸成形手术和Sky成形术,手术后即刻疼痛缓解效果类似于后凸成形术和Sky成形术,但后凸成形术和Sky成形术于术后1年及5年疼痛复现率高于经皮椎体成形术。结论经皮椎体成形术、后凸成形术和Sky成形术对老年骨质疏松椎体压缩性骨折均有较好的临床疗效,但经皮椎体成形术有更好的中期疼痛缓解效果。

COMPARISION PERCUTANEOUS VERTEBROPLASTY, KYPHOPLASTY AND SKY IN THE TREATMENTS OF OSTEOPOROSIS VERTEBRAL FRACTURES

Objective To analyze the middle- term clinical outcome of osteoporosis vertebral compression fractures(OVCF) treated with percutaneous vertebroplasty(PVP) , percutaneous kyphopasty(PKP) and Sky bone expander system(Sky). Methods From January 2002 to May 2004, 14 cases of osteoporosis VCF were treated with PVP , 8 cases of VCF were treated with PKP and 6 were treated with Sky. All of them were checked with radiography. The Cobb angle were measured from pre-operation, post-operation,1 year and 5 years after post-operation. Pain scores were evaluated by Visual Analog Scale(VAS).Results No complication appeared in all of the patients. PKP and Sky provided better restored ratio of Cobb angle than PVP.There were no difference in VAS scores between three groups in pre-operation, post-operation. But the VAS scores of PVP were better than PKP and Sky in 1 year and 5 years after post-operation. Conclusion PVP , PKP and Sky were minimally invasive, safe and potential method for the osteoporosis VCF. PKP and Sky provide better restored ratio of Cobb angle. But PVP can provide long-term pain relief.