PKP治疗骨质疏松性椎体压缩骨折术后邻椎骨折的临床效果

目的研究骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fractures，OVCFs）经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）后邻椎骨折PKP治疗效果。方法选择21例OVCFs PKP术后邻椎骨折病人，胸椎10例，腰椎11例。所有病人再次经PKP治疗，并给予规范化抗骨质疏松药物，记录手术完成情况，比较术前与术后1个月、6个月、1年疼痛视觉模拟（VAS）评分、Oswestry功能障碍指数（ODI）、椎体前缘高度比以及Cobb角，记录并发症发生情况。结果所有病人均成功完成手术，手术用时（49.45±6.43）min，出血量（23.23±4.87）mL，骨水泥注入量（4.91±1.21）mL。术后1个月、6个月、1年VAS评分和Cobb角明显低于术前，ODI指数和椎体前缘高度比明显高于术前（P < 0.01）；术后6个月、1年的VAS评分低于术后1个月（P < 0.05）、ODI指数高于术后1个月（P < 0.01）；术后1年椎体前缘高度比低于术后1个月和6个月（P < 0.05）。术后3例病人出现慢性腰痛，无切口感染、骨水泥渗漏、椎体再骨折等并发症出现。结论OVCFs PKP术后邻椎骨折再次经PKP治疗能有效降低疼痛症状，恢复椎体高度，手术安全有效。

Clinical effect of PKP in the treatment of adjacent vertebral fractures after osteoporotic vertebral compression fracture

ObjectiveTo study the effects of the percutaneous kyphoplasty(PKP) in the treatment of adjacent vertebral fractures after osteoporotic vertebral compression fractures(OVCFs).MethodsTwenty-one patients with OVCFs and 10 patients in thoracic vertebrae and 11 patients in lumbar vertebrae, were selected, and treated with PKP combined with standardized anti-osteoporosis drugs again.The operation was recorded.The pain visual analogue(VAS) scores, Oswestry dysfunction index(ODI), vertebral body height ratio and Cobb angle between before operation and after 1 month, 6 months and 1 year of operation were compared, and the incidence of complications were recorded in all cases.ResultsThe operations of all patients were successfully completed, and the time of surgery, amount of bleeding and amount of bone cement injection were (49.45±6.43) min, (23.23±4.87) mL and (4.91±1.21) mL, respectively.After 1 month, 6 months and 1 year of operation, the VAS score and Cobb angle were significantly lower than those before operation, and the ODI and vertebral body height ratio were significantly higher than those before operation(P < 0.01).After 6 months and 1 year of operation, the VAS score was significantly lower than that at postoperative 1 month, and the ODI was significantly higher than that that at postoperative 1 month(P < 0.05).The height ratio of the anterior border of the vertebral body at postoperative 1 year was significantly lower than that after 1 and 6 months of operation(P < 0.05).Three patients with chronic low back pain were found after operation, and no incision infection, bone cement leakage and vertebral body fracture occurred.ConclusionsThe PKP in treating adjacent vertebral fractures after OVCFs can effectively reduce pain symptoms, restore vertebral height, and is safe and effective.