球囊与扩张矫形器辅助的椎体后凸成形术治疗骨质疏松性椎体压缩骨折的比较

发布时间：2018-06-23 01:15

本文选题：椎体后凸成形术 + 骨质疏松压缩骨折　；参考：《中国矫形外科杂志》2017年18期

【摘要】：[目的]比较球囊辅助椎体后凸成形术(balloon kyphoplasty,BKP)和扩张矫形器辅助椎体后凸成形术(expander kyphoplasty,EKP)在治疗骨质疏松性椎体压缩骨折(osteoporosis vertebral compression fractures,OVCFs)的临床疗效差异。[方法]2014年1月~2015年1月,120例骨质疏松症合并胸腰椎单节椎体压缩性骨折患者进行椎体成形术治疗,根据手术使用器材不同,分为EKP组(60例)和BKP组(60例),分析两组患者临床资料,包括性别、年龄、手术时间,观察骨水泥注入量、测量椎体后凸角度(Cobb角法)及并发症情况,术前、术后1 d,术后1、3、6个月、1年分别采用VAS(视觉模拟评分法)评分系统评估患者疼痛情况,椎体前缘高度压缩率恢复值及后凸角度改善情况比较两组的临床疗效。[结果]两组患者性别、年龄、手术时间、术后随访时间差异无统计学意义(P0.05)。BKP组骨水泥注入量较EKP组大(5.64±0.57)ml vs.(4.28±0.51)ml(P0.05)。PKP组椎体前缘高度压缩率改善率较EKP组明显(10.87±2.32)%vs.(9.48±1.43)%(P0.05)。VAS评分改善、Cobb角改善情况、骨水泥渗漏率两组间差异无统计学意义(P0.05)。[结论]椎体后凸成形术不同辅助方式手术治疗骨质疏松压缩骨折均能获得良好的临床疗效,EKP在恢复椎体前缘高度的作用上稍逊,但因其价格相对低廉,在椎体高度丢失较小、仅需缓解疼痛及强化椎体的患者可考虑使用。
[Abstract]:[objective] to compare the clinical efficacy of balloon kyphoplastyplasty (BKP) and expander kyphoplastyplasty (expander kyphoplasty) in the treatment of osteoporotic vertebral compression fracture (osteoporosis vertebral compression fracture). [methods] from January 2014 to January 2015, 120 patients with osteoporosis complicated with thoracolumbar vertebral compression fracture were treated with vertebroplasty. The patients were divided into two groups: EKP group (n = 60) and BKP group (n = 60). The clinical data of the two groups were analyzed, including sex, age, time of operation, observation of bone cement injection, measurement of kyphosis angle (Cobb angle) and complications before operation. VAS (Visual Analog score) system was used to evaluate the pain, the recovery of anterior compression ratio and the improvement of kyphosis angle in the two groups on the 1st day, 3rd, 6th month and 1st year after operation. [results] there was no significant difference in sex, age, operation time and follow-up time between the two groups (P0.05). The amount of bone cement injected in the BKP group was larger than that in the EKP group (5.64 卤0.57) ml vs. (4.28 卤0.51) ml (, P0.05). The improvement rate of vertebral anterior height compression ratio in the PKP group was significantly higher than that in the EKP group (10.87 卤2.32) vs. (9.48 卤1.43)% (P0.05). There was no significant difference in bone cement leakage rate between the two groups (P0.05). [conclusion] different auxiliary methods of kyphoplasty in the treatment of osteoporotic compression fracture can obtain good clinical curative effect. EKP is inferior in restoring the anterior height of vertebral body, but its price is relatively low, and the loss of vertebral height is relatively small. Patients who only need pain relief and vertebral body reinforcement may consider using it.
【作者单位】：四川省骨科医院脊柱科;
【分类号】：R687.3

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