摘要
目的分析单侧经皮椎体后凸成形术(PKP)治疗老年骨质疏松性椎体压缩骨折(OVCF)的临床疗效。方法 2015年1月—2017年12月西南医科大学附属中医医院采用PKP治疗老年OVCF患者共113例,其中男性41例,女性72例;年龄70～97岁,平均75. 1岁。患者均行单侧穿刺。通过X线比较术前、术后椎体前缘、中部高度以及后凸Cobb角了解评估手术情况;通过术前、术后3d及末次随访的VAS、Oswe-stry功能障碍指数(ODI)评分系统评估临床疗效。通过术后及随访X线片、CT了解是否存在骨水泥渗漏及邻近节段再次骨折。结果患者获得随访6～24个月,平均12. 6个月。术后3d及末次随访时VAS、ODI评分、椎体前缘和中部高度以及后凸Cobb角与术前比较差异均有统计学意义(P <0. 05)。术后骨水泥渗漏4. 42%(5/113),邻近椎体再骨折发生率为2. 65%(3/113)。患者术前VAS、ODI评分、椎体前缘和中部高度以及后凸Cobb角分别为:(8. 95±0. 82)分、(85. 18±2. 99)分、(14. 33±1. 36) mm、(17. 26±1. 42) mm、(30. 55±4. 57)°,术后3d及末次随访VAS评分分别为:(3. 92±0. 79)分、(2. 11±0. 82)分,ODI评分分别为:(35. 32±5. 43)分、(32. 19±5. 33)分,椎体前缘分别为:(22. 19±1. 77) mm、(21. 15±1. 57) mm,椎体中部高度分别为:(23. 05±1. 28) mm、(22. 25±1. 18) mm,Cobb角分别为:(14. 69±3. 83)°、(15. 27±4. 36)°,术后3d及末次随访与术前相比各项指标差异均有统计学意义(P <0. 05),术后3d与末次随访的各项指标对比差异均无统计学意义(P> 0. 05)。结论单侧PKP手术治疗老年骨质疏松性椎体压缩骨折能够快速恢复椎体高度,缓解背部疼痛,改善后凸畸形,减少患者卧床时间,进而进行正常日常生活。
Objective To analyze the clinical results of unilateral percutaneous kyphoplasty(PKP)for the treatment of osteoporotic vertebral compression fractures(OVCF)in the elderly patients.Methods A total of 113 OVCF elderly patients treated with unilateral PKP from Jan.2015 to Dec.2017 were collected.There were 41 males and 72 females aged from 70-97(average,75.1)years.Totally 22 were injured from sports,12 were from traffic accidents and 4 were from other reasons.The visual analoy scale(VAS)score,Oswestry disability index(ODI),the anterior height and middle height of the vertebra and the Cobb s angle for kyphosis before and after surgery were recorded and compared to evaluate the surgery and clinical effect.All the data was recorded preoperatively and at postoperative 3d and the final follow-up separately.Bone cement leakage and adjacent vertebral refractures were observed under the X-ray and CT.Results All patients were followed up for 6-24(12.6 on average)months.Statistically significant difference was found between the preoperative and postoperative assessments and between the preoperative and the final follow-up assessments in the VAS,ODI,the anterior and middle height of the vertebra and the Cobb s angle(P<0.05).The incidence rate of cement leakage was 4.42%(5/113)postoperatively,and the incidence rate of adjacent vertebral refractures was 2.65%(3/113).The preoperative VAS,ODI score,the anterior height and middle height of the vertebra and the Cobb s angle were(8.95±0.82)points,(85.18±2.99)points,(14.33±1.36)mm,(17.26±1.42)mm,(30.55±4.57)°,respectively.The data at 3d after operation showed VAS(3.92±0.79)points,ODI(35.32±5.43)points,the anterior height of the vertebra(22.19±1.77)mm,the middle height of the vertebra(23.05±1.28)mm,Cobb s angle(14.69±3.83)°,respectively.The data at the final follow-up showed VAS(2.11±0.82)points,ODI(32.19±5.33)points,the anterior height of the vertebra(21.15±1.57)mm,the middle height of the vertebra(22.25±1.18)mm,Cobb s angle(15.27±4.36)°,respectively.The differences of 3d after operation and the final follow-up compared with that before operation were statistically significant(P<0.05),while the differences between 3d after operation and the final follow-up were not statistically significant.Conclusion Unilateral PKP in the treatment of OVCF in the elderly can quickly restore vertebral height,relieve the back pain,improve kyphosis,reduce the patients bed time and return to daily life.
作者
何远航
罗琳
李超
梁万强
罗焘
伍光辉
HE Yuan-hang;LUO Lin;LI Chao;LIANG Wan-qiang;LUO Tao;WU Guang-hui(Affiliated Hospital of Traditional Chinese Medicine Hospital of Southwest Medical University,Luzhou,Sichuan 646000,China)
出处
《创伤外科杂志》
2019年第1期22-25,共4页
Journal of Traumatic Surgery
关键词
椎体压缩骨折
后凸成形术
骨质疏松
老年
vertebral compression fracture
kyphoplasty
osteoporosis
elderly
作者简介
通信作者:伍光辉,E-mail:429601683@qq.com
