【摘要】 目的探讨骨质疏松性胸腰椎压缩骨折经皮椎体成形(PKP)术后椎体高度恢复程度与术后临床疗效的相关性。方法纳入自2010-01—2010-12行PKP手术治疗的36例骨质疏松性胸腰椎压缩骨折,计算术后3 d椎体高度恢复比的平均值,高于平均值的患者纳入A组,低于或等于平均值的患者纳入B组。比较2组术前、术后3 d、术后1年、术后5年的VAS评分、ODI指数、SF-36评分、伤椎Cobb角、伤椎椎体前缘高度。结果所有患者均成功完成手术,未出现一过性低血压、肺栓塞、感染、血肿、神经损伤等并发症。36例术后3 d的VAS评分、ODI指数、SF-36评分、伤椎Cobb角、伤椎椎体前缘高度较术前明显改善,差异有统计学意义(P<0.05)。A、B组术后3 d、1年、5年的VAS评分、ODI指数、SF-36评分、伤椎Cobb角、伤椎椎体前缘高度比较差异无统计学意义(P>0.05)。结论 PKP是治疗老年骨质疏松性椎体压缩骨折的有效术式,可缓解骨折引起的疼痛,对椎体高度的恢复及局部畸形的矫正也有一定的效果。但椎体高度恢复的程度与患者症状缓解、术后其他椎体再骨折的发生无明确的相关性。更多还原

【Abstract】 Objective To investigate the relationship between clinical efficacy and vertebral height recovery after percutaneous kyphoplasty(PKP) in the treatment of osteoporotic thoracolumbar vertebral compression fractures(OVCF). Methods From January 2010 to December 2010, 36 patients with OVCF were treated at our department and were included according to the criteria finally. The recovery of vertebral height 3 d after operation was calculated. According to the average value, all the patients were divided into two groups, the higher restoration(group A) and the lower restoration(group B). The two groups were compared in terms of visual analogue scale(VAS) score, Oswestry disability index(ODI), Cobb angle, anterior vertebral height,SF-36 score at the operation day, 3 d and one year and five years postoperatively. Results All operations were successfully completed. No complications such as transient hypotension, pulmonary embolism, infection, hematoma or nerve injury occurred. Compared with those before operation, all the patients obtained significant improvements in Cobb angle, anterior vertebral height, VAS score, ODI, and SF-36 score 3 d after operation(all P <0.05), but there were no significant differences between the 2 groups in terms of the above items 3 d and one year and five years postoperatively( P >0.05). Conclusion PKP is a safe and effective treatment of OVCF. It can alleviate the pain caused by fracture and partially rectify vertebral height and correction of local deformity. However, there is no clear correlation between the symptomatic relief or the occurrence of other vertebral fractures after the operation with different height restoration.更多还原