经皮椎体成形术与保守方法治疗脊柱骨质疏松骨折疗效分析

目的比较经皮椎体成形术（PVP）与保守治疗骨质疏松引起的椎体压缩性骨折的临床效果，探讨PVP的临床应用价值。方法选择2008年1月至2011年7月在我科治疗的骨质疏松性椎体压缩性骨折患者87例，其中PVP治疗42例（观察组），保守治疗45例（对照组），分析两组患者的治疗效果及并发症等情况。结果经比较发现，治疗前及治疗后半年，两组患者VAS和ODI评分差异无统计学意义（P〉0．05）；在治疗后第3天、1个月、3个月期间，观察组VAS和ODI评分显著低于同期的对照组患者（P〈0．05）。观察组中出现8例并发症，但均未出现脊髓及神经受压症状；对照组患者中出现褥疮1例，泌尿系感染1例，肺部感染1例。在随访的第5。6月中，观察组中有3例患者手术邻近的椎体出现压缩性骨折，对照组中有4例发生，组间比较差异不明显（P〉0．05），无统计学意义。结论PVP对于近期疼痛缓解优于保守治疗，虽然PVP方式会出现骨水泥渗漏的并发症，但能有效避免了褥疮、感染等长期卧床的并发症。

Analysis of percutaneous vertebroplasy and conservative therapy in osteoporotic vertebral compressive fractures

Objective To compare the clinical effect of percutaneous vertebroplasy（PVP） and conservative therapy in osteoporotic vertebral compressive fractures（ OVCF）, and analysis the clinical value of PVP. Methods 87 patients were selected in our department from January 2008 to July 2011, and there were 42 cases with PVP（ observation group） and 45 cases with conservative treatment（ control group）. Analysis the clinical effect and complications of the two groups and make a comparison. Results There was no difference between two groups in VAS and ODI score before operation and 6 months after treatment（ P 〉 0.05 ）. There was a significant difference between the two groups in VAS and ODI score after operative during short time, including the third day, the first month and the third month（P 〈0.05）. There were eight cases of complications which were related to bone cement leakage in PVP, but the spinal cord and nerve compression symptoms did not occurred. There were one cases of bedsore, one cases of urinary tract infection and one cases of pulmonary infection occurred in control group. There were 3 patients occurred vertebral compression fracture after 5 - 6 months in observation group, and four cases in control group with no statistical significance between the two groups （P 〉 0.05）. Conclusion PVP is an reliable treatment in OVCF, which can relieve pain quickly and effectively and avoid the complications of longterm-bed.