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椎体成形术与后凸成形术治疗老年陈旧性骨质疏松椎体压缩性骨折的相关问题探讨
Hits: 3161   Download times: 1577   Received:April 03, 2010    
作者Author单位UnitE-Mail
孙治国 SUN Zhi-guo 新疆维吾尔自治区人民医院骨一科, 新疆 乌鲁木齐 830001 Department of the First Orthopaedics, the People's Hospital of Xinjiang of Uygur Autonomous Region, Wulumuqi 830001, Xinjiang, China  
缪晓刚 MIAO Xiao-gang 新疆维吾尔自治区人民医院骨一科, 新疆 乌鲁木齐 830001 Department of the First Orthopaedics, the People's Hospital of Xinjiang of Uygur Autonomous Region, Wulumuqi 830001, Xinjiang, China  
袁宏 YUAN Hong 新疆维吾尔自治区人民医院骨一科, 新疆 乌鲁木齐 830001 Department of the First Orthopaedics, the People's Hospital of Xinjiang of Uygur Autonomous Region, Wulumuqi 830001, Xinjiang, China doctoryuanhong@sohu.com 
赵喜滨 ZHAO Xi-bin 新疆维吾尔自治区人民医院骨一科, 新疆 乌鲁木齐 830001 Department of the First Orthopaedics, the People's Hospital of Xinjiang of Uygur Autonomous Region, Wulumuqi 830001, Xinjiang, China  
王浩 WANG Hao 新疆维吾尔自治区人民医院骨一科, 新疆 乌鲁木齐 830001 Department of the First Orthopaedics, the People's Hospital of Xinjiang of Uygur Autonomous Region, Wulumuqi 830001, Xinjiang, China  
孙俊刚 SUN Jun-gang 新疆维吾尔自治区人民医院骨一科, 新疆 乌鲁木齐 830001 Department of the First Orthopaedics, the People's Hospital of Xinjiang of Uygur Autonomous Region, Wulumuqi 830001, Xinjiang, China  
期刊信息:《中国骨伤》2010年23卷,第10期,第734-738页
DOI:10.3969/j.issn.1003-0034.2010.10.005


目的:探讨椎体成形术(PVP)与后凸成形术(PKP)治疗老年陈旧性骨质疏松椎体压缩性骨折的疗效和安全性。

方法:自2004年12月至2008年6月,采用 PVP治疗 28 例(40椎)骨质疏松性椎体压缩性骨折,其中男11例(14椎),女17例(26椎);年龄70~91岁,平均72岁。骨折部位T5-L5.采用 PKP治疗 31 例(43椎),男13例(18椎),女18例(25椎);年龄70~92岁,平均74岁;骨折部位T4-L5.术后采用疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能评分、后凸 Cobb 角、椎体前中柱的平均高度及骨水泥的渗漏率等指标来评估两组疗效。

结果:两组术后 VAS 评分和Oswestry功能评分都有明显下降,与术前相比有统计学差异(P<0.01);两组间 VAS评分和Oswestry功能评分降低值无统计学意义(P>0.05).两组后凸Cobb 角及椎体前中柱的平均高度与术前比较差异无统计学意义(P>0.05).骨水泥渗漏率,PVP 组3个椎体(7.5%),PKP 组2个椎体(4.7% ),但均无神经症状。两组比较差异无统计学意义(P>0.05).

结论:PVP和 PKP 均能有效缓解老年陈旧性骨质疏松性椎体压缩性骨折所引起的疼痛,改善患者的脊柱功能,并且是一种安全有效的治疗方法。
[关键词]:骨质疏松  脊柱骨折  椎体成形术  后凸成形术  病例对照研究
 
Assessment of percutaneous vertebroplasty and percutaneous kyphoplasty for treatment of senile osteoporotic vertebral compression fractures
Abstract:

Objective: To investigate the clinical effects and safety of vertebroplasty and kyphoplasty for the senile osteoporotic vertebral compression fractures.

Methods: From December 2004 to June 2008,28 patients (40 vertebrae) with osteoporotic vertebral compression fractures were treated with percutaneous vertebroplasty (PVP group),there were 11 males (14 vertebrae) and 17 females (26 vertebrae),with an average age of 72 years (ranged,70 to 91 years). The fracture site of vertebral body was from T5 to L5. Other 31 patients (43 vertebrae) were treated with percutaneous kyphoplasty (PKP group),there were 13 males (18 vertebrae) and 18 females (25 vertebrae),with an average age of 74 years (ranged,70 to 92 years). The fracture site of vertebral body was from T4 to L5. Theapeutic effects of all the patients were observed after operation,the item included visual analog scale (VAS),Oswestry score,Cobb angle,the height of anterior and middle column vertebra,and the incidence of cement leakage.

Results: There was significant decrease in VAS score and Oswestry score after operation in both groups,there was significant difference between preoperative and postoperative(P<0.01). There was no significant difference in VAS score and Oswestry score between two groups(P>0.05). There was no significant difference in Cobb angles and the height of anterior and middle column vertebra between two groups before and after operation(P>0.05). Among them,there were 3 vertebrae cement leakage in PVP group(7.5%) and 2 in PKP group(4.7%),but no clinical sympton occurred. There was no significant difference in the incidence of cement leakage between two groups(P>0.05).

Conclusion: Vertebroplasty and kyphoplasty are safe and effective methods in treating senile osteoporotic vertebral compression fractures,which can restore the height of fractured vertebra,relieve pain and improve function as well as minimize the incidence of cement leakage.
KEYWORDS:Osteoporosis  Spinal fractures  Percutaneous vertebroplasty  Percutaneous kyphoplasty  Case-control studies
 
引用本文,请按以下格式著录参考文献:
中文格式:孙治国,缪晓刚,袁宏,赵喜滨,王浩,孙俊刚.椎体成形术与后凸成形术治疗老年陈旧性骨质疏松椎体压缩性骨折的相关问题探讨[J].中国骨伤,2010,23(10):734~738
英文格式:SUN Zhi-guo,MIAO Xiao-gang,YUAN Hong,ZHAO Xi-bin,WANG Hao,SUN Jun-gang.Assessment of percutaneous vertebroplasty and percutaneous kyphoplasty for treatment of senile osteoporotic vertebral compression fractures[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(10):734~738
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