摘要
目的比较经皮椎体成形术(PVP)术中使用高黏度骨水泥与经皮球囊扩张椎体后凸成形术(PKP)术中使用低黏度骨水泥治疗骨质疏松性胸腰椎Ⅲ度压缩性骨折的临床疗效及并发症。方法对87例患者的临床资料,进行回顾性分析,根据术式不同,将其分为PVP组42例和PKP组45例。采用视觉模拟量表(VAS)进行疼痛评分,采用Oswestry功能障碍指数(ODI)进行胸腰椎功能评分,观察并比较两组患者手术前后VAS评分、ODI指数、病椎高度及Cobb角变化情况以及术后骨水泥渗漏情况。结果两组患者术后3 d VAS疼痛评分、ODI指数较术前均有明显改善(P<0.05)。术后测量PKP组病椎高度恢复及Cobb角改善较PVP组明显(P<0.05)。术后PVP组发生椎旁软组织渗漏、椎旁静脉渗漏、椎间盘渗漏分别为7例(16.66%)、9例(21.42%)、1例(2.38%),骨水泥椎管内硬膜外渗漏、椎间孔渗漏各1例(2.38%);术后PKP组发生椎旁软组织渗漏、椎旁静脉渗漏分别为1例(2.22%)、2例(4.44%),未发生骨水泥椎间盘渗漏、椎管内硬膜外渗漏及椎间孔渗漏。结论在治疗骨质疏松性胸腰椎Ⅲ度压缩性骨折中,PVP与PKP均能快速缓解疼痛,改善胸腰椎功能活动,但PKP较PVP能更好地降低骨水泥椎旁渗漏,有效恢复病椎高度,矫正脊椎后凸畸形。
Objective： To compare the clinical efficacy and complications in the intraoperative use of high viscosity bone cement in PVP with using low viscosity bone cement in PKP in the treatment of osteoporotic third degree thoracolumbar vertebral compression fractures. Methods. The clinical data on 87 cases with third degree thoracolumbar vertebral compression fractures were retrospectively analyzed ,which was divided into PVP group （n = 42） and PKP group （n = 45） according to the methods of treatment. Visual analog scale （VAS） was used for the pain score and Oswestry Disability Index （ODI） was used for the lumbar function score. The two groups were ob- served and compared in regard to the VAS pain scores, ODI index,vertebral height,Cobb angle changes and the postoperative bone cement leakage before and after the surgery. Results： The VAS pain scores, ODI index in 3 days after the surgery were significantly improved （P〈 0.05 ）. The vertebral height restoration and Cobb angle im- provement in the PKP group was significantly improved compared with that of the PVP group （P〈 0.05 ） after the surgery. The number of paints with paraspinal soft tissue leakage, venous paravertebral leakage,intervertebral disc leakage were 7 cases （16.66%）,9 cases （21.42%）,and 1 cases （2.38%） respectively. Moreover,the number of paints with bone cement spinal epidural leakage and foraminal leakage were both 1 case （2.38%） in the PVP group. The number of paints with paraspinal soft tissue leakage and venous paravertebral leakage were 1 case （2.22%） ,2 cases（4.44%） respectively and there was no case with bone cement intervertebral disc leakage,spinal epidural leakage and foraminal leakage in the PKP group. Conclusion： In the treatment of osteoporotic third degree thoracolumbar vertebral compression fractures, both PKP and PVP can quickly relieve pain and improve tho-racolumbar functional activities. Compared with PVP,PKP can lower the occurrence of bone cement paravertebral leakage and has curative effect on the vertebral height correction of spinal kyphosis.
作者
彭冉东
邓强
李中锋
张彦军
韩宪富
李军杰
PENG Randong DENG Qiang Ll Zhongfeng et al(Graduate School of Gansu University of Chinese Medicine, Gansu, Lanzhou 730000, Chin)
出处
《中国中医急症》
2016年第10期1926-1929,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
卫生部医药卫生科技发展研究中心科研基金(W2014ZT210)
甘肃省中医药管理局科研课题(CZK-2016-49)
国家中医药管理局国家中医临床研究基地业务建设科研专项课题(JDZX2015039)
