| 冯晶,夏平,肖少雄.体位加手法复位结合经皮椎体成形术治疗老年骨质疏松性椎体压缩骨折的临床观察[J].,2012,32(10):1350-1353 |
| 体位加手法复位结合经皮椎体成形术治疗老年骨质疏松性椎体压缩骨折的临床观察 |
| Clinical Observation of Treating Osteoporosis Vertebral Compression Fracture of Senile Patients by Restitution Combined Percutaneous Vertebroplasty |
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| DOI： |
| 中文关键词: 经皮椎体成形术 经皮椎体后凸成形术 骨质疏松性椎体压缩骨折 矫形复位 |
| 英文关键词:percutaneous vertebroplasty percutaneous kyphoplasty osteoporosis vertebral compression fracture orthopedic restitution |
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| 中文摘要: |
| 目的探讨体位加手法复位结合经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折(osteoporosis vertebral compression fracture,OVCF)的方法及临床疗效。方法选择愿意接受微创介入治疗的老年OVCF患者132例,其中综合治疗组68例89个椎体,行体位加手法复位结合PVP治疗;PKP组64例81个椎体,单纯行经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗,所有患者均随访3年以上。手术前后采用视觉模拟疼痛评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)评分、Cobb’s角及病椎前缘、中部高度比值等指标进行临床疗效评价,并比较两组单个椎体手术时间、术中透视时间、骨水泥渗漏发生率、骨水泥注入量、住院费用及住院天数。结果与本组术前比较,术后两组VAS评分及ODI评分均明显下降,病椎前缘、中部高度比值和Cobb’s角均明显改善,差异有统计学意义(P<0.01);术后相同时间点上述指标组间比较,差异均无统计学意义(P>0.05)。两组患者骨水泥渗漏发生率、骨水泥注入量及住院天数比较,差异均无统计学意义(P>0.05),但综合治疗组单个椎体手术时间、术中透视时间及住院费用均明显少于PKP组(P<0.01)。结论体位加手法复位结合PVP治疗OVCF能达到与PKP相同的临床效果,有效恢复病椎高度,矫正脊椎后凸畸形,且骨水泥渗漏发生率未见差异。 |
| 英文摘要: |
| Objective To explore the methods and therapeutic efficacy of restitution combined with percutaneous vertebroplasty (PVP) for treating osteoporosis vertebral compression fracture (OVCF). Methods Recruited were 132 senile patients with OVCF who were willing to receive minimally invasive therapy were assigned to the comprehensive treatment group and the percutaneous kyphoplasty (PKP) group. The 89 vertebral bodies in the 68 cases of the comprehensive treatment group received restitution combined with PVP, while the 81 vertebral bodies in the 64 cases of the control PKP group received PKP alone. All patients completed the follow-ups for more than 3 years. The therapeutic efficacy was assessed using visual analogue scale (VAS), Oswestry disability index (ODI), Cobb′s angle, the height ratios of the diseased vertebral anterior edge and middle edge. The operation time for a single centrum, the perspective time during the operation, the incidence of bone cement leakage, the injection rate of the bone cement, the cost of hospitalization, and the hospital days were compared between the comprehensive treatment group and the PKP group. Results Compared with before treatment in the same group, the VAS and ODI were significantly lower, the height ratios of the diseased vertebral anterior edge and middle edge, and the Cobb′s angle were obviously improved in the two groups, showing statistical difference (P<0.01). There was no significant difference in the aforesaid indices between the two groups after treatment at the same time point (P>0.05). There was no significant difference in the incidence of bone cement leakage, the injection rate of the bone cement, or the hospital days between the two groups (P>0.05). But the operation time for individual vertebral body, the perspective time during the operation, and the cost of hospitalization were obviously less in the comprehensive treatment group than in the PKP group (P<0.01). Conclusions Restitution combined PVP could achieve the same therapeutic efficacy as that of the PKP. It could effectively restore the diseased vertebral height and correct the spinal kyphosis. Besides, there was no statistical difference in the incidence of bone cement leakage. |
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