2种成形术治疗胸腰椎骨质疏松性压缩骨折疗效分析

目的比较经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)对胸腰椎骨质疏松性压缩骨折的疗效,并分析相关影响因素。方法选择解放军第188医院收治的骨质疏松性胸腰椎压缩骨折患者共176例,根据治疗方式不同将患者分为PVP组102例及PKP组74例。比较2组患者手术时间、住院时间、骨水泥注射量、Cobb角及治疗有效率,视觉模拟评分法(VAS)评估2组手术前后疼痛情况,分析影响PVP治疗的相关因素。结果 PVP组患者手术时间、住院时间均显著短于PKP组,差异有统计学意义(P<0.05)。2组术后24 h及术后1个月VAS评分均显著低于术前,差异有统计学意义(P<0.05)。2组术后Cobb角均较术前显著降低,差异有统计学意义(P<0.05)。2组治疗有效率比较差异无统计学意义(P>0.05)。行PVP治疗、病程<6个月的患者治疗有效率(98.4%)显著高于病程≥6个月的患者(73.6%),差异有统计学意义(P<0.05)。结论 PVP治疗胸腰椎骨质疏松性压缩骨折的疗效明显优于PKP;病程长短会影响PVP的治疗效果。

Curative effect of two vertebro-plasty for osteoporotic vertebral compression fractures of thoracolumbar

Objective To compare the curative effect of percutaneous vertebroplasty(PVP) and percutaneous kyphoplasty(PKP)for osteoporotic vertebral compression fractures of thoracolumbar and analyze the related influential factors.Methods A total of 176 patients who suffered osteoporotic vertebral compression fractures of thoracolumbar from No.188 Hospital of People′s Liberation Army were chosen and then divided into two groups according to the different ways of treatment,including the PVP group with 102 cases and the PKP group with 74 cases.The surgery time,hospital stay,amount of injection bone cement,cobb′s angle and treatment effective rate in the two groups were compared,and the condition of pain for the two groups were assessed by visual analogue score(VAS) before and after surgery in order to find out related factors which affected the curative effect of PVP.Results Surgery time and hospital stay of the PVP group were shorter significantly than those of the PKP group(P<0.05).The VAS of the PVP group and the PKP group 24 h and 1 month after surgery decreased significantly than those of the two groups before surgery(P<0.05).Cobb′s angle of the PVP group and the PKP group after surgery decreased significantly than those of the two groups before surgery(P<0.05).However,there was no significant difference in the comparison of treatment effectiveness of the two groups(P>0.05).It also found that treatment effectiveness of patients with course of disease less than 6 months(98.4%) was obviously higher than that of patients with course of disease more than 6 months(73.6%) in PVP group,which showed significant difference(P<0.05).Conclusion Curative effect of PVP on osteoporotic vertebral compression fractures of thoracolumbar is obviously better than that of PKP.The course of disease has a direct effect on treatment effectiveness of PVP.