PKP治疗不同时期骨质疏松性椎体压缩骨折的结果比较

目的探讨经皮椎体后凸成形术（percutaneous kyphoplasty,PKP）对不同时期骨质疏松骨折患者的疗效,从而探讨PKP治疗骨质疏松椎体骨折的最佳手术时机。方法回顾性分析2008年9月至2011年9月随机接受PKP治疗的106例患者,按照骨折至接受PKP时间分为急性期组、亚急性期组和慢性期组,于不同时间点通过视觉模拟疼痛评分（visual analogue scale,VAS）、骨水泥渗漏率确定各组疗效。结果急性期组、亚急性期组术后24h及术后3个月VAS评分与术前比较差异有统计学意义（P〈0.05）,慢性期组术后24h VAS评分与术前比较差异无统计学意义（P〉0.05）,随访至术后3个月时差异有统计学意义（P〈0.05）。骨水泥总渗漏率16.3%,其中亚急性组4.4%,较急性期组的17.6%及慢性期组的21.2%差异有统计学意义（P〈0.05）。结论 PKP是一种治疗老年骨质疏松椎体压缩骨折有效的微创方法,选择急性期或亚急性期治疗效果更优,尤其是亚急性期骨水泥渗漏率最低。选择慢性期行PKP治疗仍可获得一定远期疗效,但要注意其有着较高的骨水泥渗漏风险。

Comparison the Percutaneous Kyphoplasty Performed at Different Times after Osteoporotic Verte- bral Compression Fractures

Objective To evaluate the effect of percutaneous kyphoplasty （PKP）at different times aiter osteo- porotie vertebral compression fractures. Methods In this retrospective study,106 patients who underwent one level of PKP between September 2008 and September 2011 were reviewed. The patients were divided into three groups： within 2 weeks after injury （the acute group）,2 weeks to 2 months after injury （the subacute group）,2 months after an injury （the chronic group）. Clinical outcomes were assessed using visual analogue scale （VAS） and bone cement leakage was also evaluated. Results Patients in all three groups achieved marked pain relief in terms of the VAS after the 3 month follow-up （P〈0.05）. However ,there was no significant pain relief at 24 h after PKP in the chronic group （P〈0.05）. Moreover ,evidence of complications including cement leakage was observed significantly less frequently in the subacute group compared to the other two groups（P〈0.05）. Conclusion PKP is an effective and minimally inva- sive method in treatment of senile osteoporosis vertebral compression fracture,satisfactory effect outcome after PKP in acute and subacute phase,The subacute phase group has the lowest bone cement leakage rate. Although the chronic group achieved marked pain relief after 3 month,hut must pay attention to the higher bone cement leakage risk.