摘要
目的通过临床对比研究分析椎体后凸成形术治疗骨质疏松性脊柱骨折的临床疗效。方法 2006年3月-2007年8月,收治60例骨质疏松性脊柱骨折患者。其中40例选择椎体后凸成形术治疗(试验组),20例选择保守治疗(对照组)。试验组:男6例,女34例;年龄56～78岁,平均68.7岁。病程10～18个月,平均12个月。骨折涉及73个椎体。对照组:男5例,女15例;年龄57～80岁,平均70.1岁。病程9～16个月,平均13个月。骨折涉及41个椎体。两组患者性别、年龄、病程、疼痛视觉模拟评分(VAS)、欧洲脊柱骨质疏松症研究(EVOS)问卷评分,以及伤椎前中柱椎体高度、后凸Cobb角比较,差异均无统计学意义(P>0.05),具有可比性。结果试验组患者术后切口均Ⅰ期愈合,无骨水泥渗漏。两组患者均获随访,随访时间36～38个月。试验组治疗后1～3 d及12、36个月VAS评分、EVOS评分、伤椎前中柱椎体高度及后凸Cobb角均较术前明显改善(P<0.05);对照组治疗后以上指标与术前比较无改善(P>0.05)。治疗后12、36个月,试验组以上指标均优于对照组(P<0.05)。治疗后36个月,对照组患者新发脊柱骨折发生率高于试验组(χ2=16.347,P=0.015)。结论椎体后凸成形术治疗骨质疏松性脊柱骨折后,疼痛症状可明显缓解,活动功能恢复,且新发脊柱骨折发生率较保守治疗低。
Objective To investigate the effectiveness of kyphoplasty in treating osteoporotic vertebral fracture according to comparative study. Methods Between March 2006 and August 2007, 60 patients with osteoporotic vertebral fractures were treated. Kyphoplasty was performed in 40 patients （test group） and conservative treatment was performed in 20
patients as control （control group）. In test group, there were 6 males and 34 females with an average age of 68.7 years （range, 56-78 years）. The disease duration was 10-18 months （mean, 12 months）. A total of 73 vertebral bodies fractured. In control group, there were 5 males and 15 females with an average age of 70.1 years （range, 57-80 years）. The disease duration was 9-16 months （mean, 13 months）. A total of 41 vertebral bodies fractured. There was no significant difference in the general data between 2 groups （P 〉 0.05）. Results All incisions healed by first intention in test group, and no leakage of bone cement occurred. The patients of 2 groups were followed up 36-38 months. The visual analogue scale （VAS） scores, European Vertebral Osteoporosis Study （EVOS） questionnaire scores, anterior and middle vertebral column heights, and Cobb angles of test group at 1-3 days, 12 and 36 months after treatment were significantly improved when compared with those before operation （P 〈 0.05）; but there was no significant difference between before treatment and after treatment in control group （P 〉 0.05）. After 12 and 36 months, the VAS scores, EVOS scores, anterior and middle vertebral column heights, and Cobb angles of test group were better than those of control group （P 〈 0.05）. The incidence of vertebral re-fractures was higher in control group than in test group after 36 months （χ2=16.347, P=0.015）. Conclusion Kyphoplasty can effectively rel ieve pain and restore the function after the procedure. The risk of vertebral re-fractures after kyphoplasty can be reduced in comparison with conservative treatment.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2011年第3期303-306,共4页
Chinese Journal of Reparative and Reconstructive Surgery
