【摘要】 目的:研究经皮椎体后凸成形术(PKP)与过伸复位联合经皮椎体成形术(PVP)治疗老年骨质疏松性胸腰椎压缩性骨折的效果。方法:选取2015年6月—2018年12月本院收治的老年骨质疏松性胸腰椎压缩性骨折患者100例。按照治疗方法不同将其分为A组和B组,各50例。A组行PKP手术治疗,B组行过伸复位联合PVP手术治疗,比较两组手术时间、出血量、骨水泥渗漏风险、住院费用及时间、疼痛评分、病椎Cobb角、病椎高度、椎体高度压缩率和恢复率。结果:两组骨水泥渗漏率、术中出血量、住院时间比较,差异均无统计学意义(P>0.05),A组治疗费用多于B组、手术时间长于B组,差异均有统计学意义(P<0.05);两组手术前后VAS评分比较,差异均无统计学意义(P>0.05),但两组术后3 d、2个月的VAS评分均低于术前(P<0.05);术后,A组病椎高度、病椎Cobb角、椎体压缩率、椎体高度恢复率均优于B组,差异均有统计学意义(P<0.05)。结论:对于骨质疏松性胸腰椎压缩性骨折患者,采取过伸复位联合PVP手术治疗,操作简便,术后疼痛可得到有效缓解,且治疗费用低,整体疗效确切;采用PKP手术治疗同样可快速缓解疼痛,虽治疗费用较高,却可明显恢复病椎高度、纠正后凸畸形;两种手术方法治疗效果均理想,安全性均较高。在临床中可根据患者自身情况将PKP术和过伸复位联合PVP术灵活应用,更好地造福广大患者。更多还原

【Abstract】 Objective:To compare the effect of percutaneous kyphoplasty(PKP)and hyperextension reduction combined with percutaneous vertebroplasty(PVP)in elderly osteoporotic thoracolumbar vertebral compression fracture.Method:A total of 100 elderly patients with osteoporotic thoracolumbar vertebral compression fractures admitted to our hospital from June 2015 to December 2018 were selected.According to different treatment methods,they were divided into group A and group B,50 cases in each group.The PKP was performed in group A,the hyperextension reduction combined with PVP was performed in group B.The operation time,bleeding volume,risk of cement leakage,hospitalization cost and time,pain score(VAS),Cobb angle of diseased vertebrae,height of diseased vertebrae,compression rate and recovery rate of vertebral height between two groups were compared.Result:The cement leakage rate,intraoperative bleeding volume and hospitalization time in two groups were compared,the differences were no statistically significant(P>0.05).The hospitalization cost in group A was higher than that of group B,the operation time was no longer than that of group B,the differences were statistically significant(P<0.05).The VAS scores of two groups before and after operation were compared,the differences were no statistically significant(P>0.05),but the VAS scores of 3 days and 2 months after operation in two groups were lower than those of before operation(P<0.05).After operation,the height of diseased vertebrae,Cobb angle of diseased vertebrae,vertebral compression rate and recovery rate of vertebral height in group A were better than those of group B,the differences were statistically significant(P<0.05).Conclusion:For patients with osteoporotic thoracolumbar vertebral compression fracture,hyperextension reduction combined with PVP operation is simple and easy to operate,and the pain can be effectively relieved after operation,and the cost of treatment is low,the overall effect is definite;PKP operation can also quickly relieve pain,although the cost of treatment is high,it can significantly restore the height of the diseased vertebra and correct kyphosis deformity.All of them are ideal and safe,in clinic,PKP and overextension reduction combined with PVP can be applied flexibly according to the patient’s own condition,so as to better benefit the patients.更多还原