老年骨质疏松性椎体压缩性骨折不愈合诊治分析

目的探讨老年骨质疏松性椎体压缩性骨折不愈合的诊治方法 ,分析经皮椎体成形术（PVP）与经皮椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩性骨折的疗效。方法回顾性分析2011年10月～2012年12月收治的20例老年骨质疏松性椎体压缩性骨折不愈合患者的临床资料。15例患者行PVP手术,5例患者行PKP手术。术后采用疼痛视觉模拟评分（VAS）、伤椎前缘、中部高度丢失百分比（%）评估治疗效果。结果经影像学评估显示,术后患者病椎高度明显增加,术后3 d病椎高度（16.2±2.4）mm]与术前（12.1±1.5）mm]比较差异有统计学意义（t=6.479,P=0.029〈0.05）,但术后1个月与术后3 d比较,差异无统计学意义（t=1.402,P=0.14〉0.05）。全部患者疼痛症状均得到明显缓解,术后3 d患者VAS评分（1.3±0.2）分]与术前（8.5±1.1）分]比较差异有统计学意义（t=29.600,P=0.02〈0.05）,但术后1个月与术后3 d比较,差异无统计学意义（t=1.240,P=0.59〉0.05）。结论 PVP及PKP手术都能有效缓解骨质疏松性椎体压缩性骨折不愈合患者的胸背部疼痛,具有创伤小、手术时间短、并发症少,早期疗效确切等优点,明显提高了患者的生活质量。

Diagnosis and analysis of nonunion of senile osteoporotic vertebral compression fractures

Objective To explore the diagnosis and analysis methods of nonunion of senile osteoporotic vertebral compression fractures, and analyze the effect of percutaneous vertebralplasty（PVP） and percutaneous kyphoplasty（PKP） to treat osteoporotic vertebral compression fractures. Methods The clinical date of 20 patients with senile osteoporotic vertebral compression fractures nonunion from October 2011 to December 2012 were reviewed retrospectively. 15 patients treated by PVP, 5 patients underwent PKP. After operation, used pain visual analogue scale（VAS）, fractured vertebra front, middle height percentage（%） to evaluate treatment effects. Results Radiographic assessment showed that postoperative patients with vertebral height increased, after operation 3 d was（16.2±2.4） mm, compared with preoperative（12.1±1.5） mm], there was a significant difference（t=6.479, P=0.0290.05）, but after operation 1 month and after operation3 d, the difference was not statistically significant（t=1.402, P=0.140.05）. All pain symptoms were significantly reduce in patients with postoperative, VAS scores in patients after operation 3 d were（1.3±0.2） scores, compared with preoperative （8.5±1.1）] scores, there was a significant difference（t=29.600, P=0.020.05）, but after operation 1 month and after operation 3 d, the difference was not statistically significant（t =1.240, P =0.59 0.05）. Conclusion PVP and PKP surgery can effectively alleviate the osteoporotic vertebral body compression fracture nonunion cause thoracic back pain, the surgery with many advantages, such as less trauma and shorter surgery time, fewer complications, early therapeutic, it can significantly improves a patient＇s quality of life.