摘要
目的探讨经皮椎体成形术与经皮椎体后凸成形术治疗老年轻中度骨质疏松性胸腰椎压缩性骨折的临床比较。方法选取我院(2015年1月至2017年1月)收治的90例老年骨质疏松性胸腰椎压缩性骨折患者,根据不同治疗方法分为两组,经皮椎体成形术组45例,经皮椎体后凸成形术组45例,对比两组患者围术期相关指标和手术前后椎体前缘高度、Cobb's角、疼痛程度、活动能力以及并发症发生率。结果经皮椎体成形术组患者手术时间和住院时间明显短于经皮椎体后凸成形术组,骨水泥注入量明显低于经皮椎体后凸成形术组,差异具有统计学意义(P<0.05)。术前两组患者椎体前缘高度和Cobb's角对比无明显差异(P>0.05);术后3d、3个月经皮椎体成形术组患者椎体前缘高度明显低于经皮椎体后凸成形术组,差异具有统计学意义(P<0.05);术后3d、3个月两组患者Cobb's角对比无明显差异(P>0.05),但与术前相比均明显改善,差异具有统计学意义(P<0.05)。术前、术后3d、术后3个月、术后6个月、术后12个月两组患者VAS评分对比无明显差异(P>0.05),但术后3d、术后3个月、术后6个月、术后12个月两组患者VAS评分均较术前明显降低,差异具有统计学意义(P<0.05)。术前、术后3d、术后3个月、术后6个月、术后12个月两组患者活动能力评分对比无明显差异(P>0.05),但术后3d、术后3个月、术后6个月、术后12个月两组患者活动能力评分均较术前明显降低,差异具有统计学意义(P<0.05)。两组患者并发症发生率13.33%vs20.00%对比差异不明显,无统计学意义(P>0.05)。结论两种手术均可以缓解疼痛,恢复活动能力,经皮椎体成形术更为简便,经皮椎体后凸成形术可更好的恢复椎体高度,各具优劣势。
Objective To investigate the clinical comparison of percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of elderly patients with mild to moderate osteoporotic thoracolumbar compression fractures.Methods Ninety elderly patients with osteoporotic thoracolumbar vertebral compression fractures admitted to our hospital(January 2015-January 2017)were divided into two groups according to different treatment methods:percutaneous vertebroplasty group(45 cases)and percutaneous kyphoplasty group(45 cases).The perioperative indexes,anterior height of vertebral body and Cobb's height before and after operation were compared between the two groups.Angle,degree of pain,mobility and incidence of complications.Results The operation time and hospitalization time of percutaneous vertebroplasty group were significantly shorter than that of percutaneous vertebroplasty group,and the amount of bone cement injection was significantly lower than that of percutaneous vertebroplasty group(P<0.05).There was no significant difference in the anterior vertebral height and Cobb's angle between the two groups before operation(P>0.05);the anterior vertebral height in the percutaneous vertebroplasty group was significantly lower than that in the percutaneous kyphoplasty group 3 days and 3 months after operation(P<0.05);and there was no significant difference in the Cobb's angle between the two groups 3 days and 3 months after operation(P>0.05).but compared with the preoperative,the difference was statistically significant(P<0.05).There was no significant difference in VAS score between the two groups before operation,3 days after operation,3 months after operation,6 months after operation and 12 months after operation(P>0.05),but the VAS score of the two groups decreased significantly after 3 days,3 months after operation,6 months after operation and 12 months after operation(P<0.05).There was no significant difference in activity scores between the two groups before operation,3 days after operation,3 months after operation,6 months after operation and 12 months after operation(P>0.05),but activity scores of the two groups were significantly lower than those before operation at 3 days,3 months after operation,6 months after operation and 12 months after operation(P<0.05).There was no significant difference in the incidence of complications between the two groups(13.33%vs 20.00%,P>0.05).Conclusion Both operations can relieve pain and restore mobility.Percutaneous vertebroplasty is simpler.Percutaneous kyphoplasty can restore vertebral height better,with advantages and disadvantages.
作者
李林
LI Lin(Department of Orthopedics,Yantai Muping District TCM Hospital,Yantai 264100,China)
出处
《中国医药指南》
2019年第15期14-15,17,共3页
Guide of China Medicine
关键词
经皮椎体成形术
经皮椎体后凸成形术
老年
轻中度
骨质疏松性
胸腰椎压缩性骨折
Percutaneous vertebroplasty
Percutaneous kyphoplasty
Old age
Mild to moderate
Osteoporosis
Thoracolumbar vertebral compressionfracture
