骨质疏松性椎体骨折不同时期行经皮椎体成形术疗效比较

目的观察骨质疏松性椎体骨折(OVF)不同时期患者行经皮椎体成形术(PVP)治疗的临床效果。方法选择行PVP的OVF患者120例,根据损伤至手术时间不同分为损伤2周内手术(A组)65例、损伤第2~8周手术(B组)35例、损伤2个月后手术(C组)20例。比较三组患者术前、术后3 d、术后6个月时的疼痛视觉模拟评分(VAS)、欧洲骨质疏松症基金会生活质量问卷(QUALEFFO)评分;比较三组患者骨水泥分布情况、骨水泥注入量、骨水泥渗漏率。结果三组患者各组内比较,术后3 d的VAS均低于术前,术后6个月的VAS均低于术后3 d(P<0.05);术后6个月、术后3 d的QUALEFFO评分均低于术前(P<0.05)。三组同时点VAS、QUALEFFO评分差异均无统计学意义(P均>0.05)。三组骨水泥注入量、骨水泥渗漏率、骨水泥分布指数比较差异均有统计学意义(P均<0.05)。结论PVP在治疗不同时期OVF中均有良好效果。急性期骨水泥分布指数高,而在亚急性期、慢性期则分别存在骨水泥渗漏率较低、骨水泥注入量减少的情况。建议对于OVF患者应早期进行PVP治疗。

Comparison of percutaneous vertebroplasty at different stages of osteoporotic vertebral fractures

Objective To investigate the clinical effect of percutaneous vertebroplasty(PVP)in the treatment of os?teoporotic vertebral fractures(OVF).Methods A total of 120 patients with OVF underwent PVP were divided into three groups according to the time from injury to operation:group A(n=65,operation within 2 weeks after injury),group B(n=35,operation within 2-8 weeks after injury)and group C(n=20,operation was performed 2 months after injury).The visu?al analogue scale(VAS)and quality of life questionnaire of the European Foundation for osteoporosis(QUALEFFO)scores were compared before operation,3 days after operation and 6 months after operation;the distribution of bone ce?ment,the amount of bone cement injected and the leakage rate of bone cement were compared among the three groups.Re?sults Within each group,the VAS of the three groups were lower than that before operation,and the VAS of the six months after operation were lower than that of the three days after operation(P<0.05);the QUALEFFO scores of the six months after operation and the three days after operation were lower than those before operation(P<0.05).There was no significant difference in VAS score and QUALEFFO score among the three groups at the same time point(P>0.05).There were significant differences in bone cement injection volume,bone cement leakage rate and bone cement distribution index among the three groups(P<0.05).Conclusion PVP has a good effect in the treatment of OVF at different stages,with high bone cemen tdistribution index in the acute stage,low bone cement leakage rate and reduced bone cement injection in the subacute and chronic stages,respectively.It is suggested that early PVP should be performed in OVF patients.