摘要
目的比较经皮椎体成形术(percutaneous vertebroplasty, PVP)与关节突封闭(facet blocking, FB)治疗骨质疏松性椎体压缩骨折的疗效。方法选取2015年1月至2019年6月因骨质疏松性椎体压缩骨折接受PVP与FB治疗的患者162例,其中PVP组(接受PVP治疗)86例,FB组(接受FB治疗)76例,比较两组围手术期相关指标、伤椎前缘高度、矢状位后凸Cobb角、术前和术后随访(1 d、1周、1个月、3个月、6个月、12个月)的视觉模拟评分(visual analogue scale,VAS)、功能障碍指数(oswestry disability index, ODI)、腰椎功能障碍评分(roland morris disability, RMD)评分。结果PVP组手术时间(34.25±6.04)min与FB组(21.47±4.58)min比较,差异有统计学意义(P<0.05)。术前两组伤椎前缘高度比较差异无统计学意义(P>0.05);PVP组和FB组术后3 d、6个月、12个月伤椎前缘高度有统计学差异(P<0.05),FB组术后3 d、6个月、12个月伤椎前缘高度较术前无明显变化。两组术前Cobb角比较差异无统计学意义(P>0.05),术后PVP组与FB组存在统计学差异(P<0.05)。PVP组患者术后1 d与1周内的VAS、ODI、RMD评分明显低于FB组(P<0.001),而随访1个月以上时VAS、ODI、RMD评分无统计学差异(P>0.05)。结论 PVP组和FB组均能有效缓解疼痛;对部分患者,如贫困、高龄、可耐受疼痛患者,FB可以成为代替PVP的治疗方式。
Objective To compare the efficacy of percutaneous vertebroplasty(PVP)and facet blocking(FB)in the treatment of osteoporotic vertebral compression fractures. Methods From January 2015 to June 2019, 162 patients with osteoporotic vertebral compression fracture were treated with PVP and FB. Among them,PVP group(86 cases)received PVP treatment and FB group(76 cases)received FB treatment. We compared the perioperative related indexes,the height of the anterior edge of the injured vertebrae, the sagittal kyphosis Cobb angle, visual analogue score, dysfunction index and lumbar dysfunction score of preoperative and postoperative follow-up(1 day,1 week,1 month,3 months,6 months,and 12 months)in both groups. Results There was significant difference in operation time between PVP group[(34. 25±6. 04)min)]and FB group[(21. 47±4. 58)min](P<0. 05). There was no significant difference in the height of the anterior edge of injured vertebra between the two groups before operation(P>0. 05),but there was significant difference in the height of anterior margin of injured vertebrae between the two groups at 3 days, 6 months and 12 months after operation(P<0. 05). In FB group, there was no significant change in the height of the anterior edge of the injured vertebrae at 3 days, 6 months and 12 months after operation. The two groups did not significantly differ in Cobb angle before operation(P>0. 05),but after operation(P<0. 05). The scores of VAS,ODI and RMD were lower in PVP group than in FB group 1 day and 1 week after operation(P<0. 05),but they did not significantly differ after follow-up for more than one month(P>0. 05). Conclusion Both PVP group and FB group have effectively relieved pain. The results of this study suggest that FB can become an alternative treatment for PVP in some patients, such as the poor, elderly and paintolerant ones.
作者
白航航
高伟
仉培武
李征宇
卢洋
郭华
BAI Hanghang;GAO Wei;ZHANG Peiwu;LI Zhengyu;LU Yang;GUO Hua(Department of Orthopedics,Xi’an Central Hospital,Medical College of Xi’an Jiaotong University,Xi’an 710003,China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2021年第6期808-812,共5页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
陕西省自然科学基础研究项目(No.2021JZ-58)
西安市科技计划项目[No.20YXYJ0004(3)]
西安市卫生健康委员会科技计划项目(No.2020yb02)。
关键词
骨质疏松
椎体压缩骨折
经皮椎体成形术
关节突封闭术
脊柱微创
osteoporosis
vertebral compression fracture
percutaneous vertebroplasty
facet blocking
minimally invasive spine
作者简介
通信作者:郭华,主任医师.E-mail:13991817800@139.com。
