骨质疏松性椎体压缩骨折椎体后凸成形术与非手术治疗的临床对照研究

目的比较经皮椎体后凸成形术（PKP）与非手术治疗骨质疏松性椎体压缩骨折（OVCF）的临床疗效。方法对自2009-04--2012—04收治的94例OVCF患者非随机分为手术组40例和非手术组54例。随访1年，记录患者疼痛评分、卧床时间、并发症及新发椎体骨折情况。计算术后伤椎前缘高度丢失率和Cobb角，进行组间比较。结果治疗后前1个月手术组疼痛缓解明显好于非手术组（P〈0．05），1个月后疼痛缓解无明显差异（P〉O．05）；手术组卧床时间明显短于非手术组（P〈O．01）；1年后，手术组伤椎前缘高度丢失率及Cobb角明显小于较非手术组（P〈0．01）；2组新发椎体骨折风险差异无统计学意义（HazardRatio=1．12，P=0．83）。结论与非手术治疗相比，PKP可在早期明显减轻OVCF患者的疼痛并缩短卧床时间、改善伤椎后凸畸形且并不增加新发椎体骨折风险，但对于远期疼痛改善无显著优势。

A clinical trial of percutaneous kyphoplasty and conservative therapy for osteoporotic vertebral compression fractures

Objective To compare the clinical effect of percutaneous kyphoplasty （PKP） and conservative therapy for osteoporotic vertebral compression fractures （OVCF）. Methods From April 2009 to April 2012,94 patients with OVCF were distributed to PKP group and conservative treatment group according to the will and economic condition of patients. The follow-up was for 1 year, the VAS scores at the different point of follow-up, the time in bed, cases of complication, risk of new vertebral fractures, postoperative loss rate of vertebral anterior height and Cobb angle were recorded and calculated after the treatment. The differences were analyzed between the two groups. Results The pain relief in the first month follow-up, the time in bed, the loss rate of vertebral anterior height and Cobb angle at the time of 1-year between the two groups were significantly different（P 〈0.05）. No significant difference was observed in the pain relief after 1 month（P 〉0.05）. The difference of risk of new fractures was not significant between the two groups （Hazard Ratio=l.12, P =0.83）. Conclusion The PKP can significantly relieve the pain in early stage, shorten the time in bed and correct vertebral deformities for patients with OVCF. Meanwhile, the PKP does not increase the risk of new vertebral fracture compared with conservative treatment. However, for the long-term follow-up, no difference of pain relief was observed between the two groups.