[1]邓强△ 彭冉东 李中锋 张彦军 韩宪富 李军杰.PVP与PKP治疗骨质疏松性胸腰椎Ⅰ度压缩骨折的临床疗效观察[J].中国中医骨伤科杂志,2016,24(12):7-12.
　DENG Qiang PENG Randong LI Zhongfeng ZHANG Yanjun HAN Xianfu LI Junjie.Clinical Efficacy of PVP and PKP for Treating Osteoporotic Thoracolumbar Compression Fractures of Degree Ⅰ[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2016,24(12):7-12.
点击复制

PVP与PKP治疗骨质疏松性胸腰椎Ⅰ度压缩骨折的临床疗效观察
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第24卷
期数:
2016年12期
页码:
7-12
栏目:
临床研究
出版日期:
2016-12-05

文章信息/Info

Title:
Clinical Efficacy of PVP and PKP for Treating Osteoporotic Thoracolumbar Compression Fractures of Degree Ⅰ
作者:
邓强1△ 彭冉东2 李中锋1 张彦军1 韩宪富2 李军杰2
Author(s):
DENG Qiang1△ PENG Randong2 LI Zhongfeng1 ZHANG Yanjun1 HAN Xianfu2 LI Junjie2
1Gansu Hospital of Traditional Chinese Medicine,Lanzhou 730050,China; 2Gansu University of Traditional Chinese Medicine,Lanzhou 730050,China.
关键词:
经皮椎体后凸成形术(PKP);  经皮椎体成形术(PVP);  Ⅰ度压缩性骨折;  骨水泥;  骨水泥弥散
Keywords:
PKP;  PVP;  I degree compression fractures;  bone cement;  cement dispersion
分类号:
R683.1
文献标志码:
A
摘要:
目的:比较PVP与PKP治疗骨质疏松性胸腰椎Ⅰ度压缩骨折的临床疗效及并发症。方法:回顾性分析63例骨质疏松性胸腰椎Ⅰ度压缩骨折患者的临床资料,根据手术方法不同,将其分为PVP组(30例)和PKP组(33例)。观察并比较两组患者术后骨水泥在骨折线内的弥散情况、病椎高度丢失率及Cobb角变化情况以及手术前后Oswestry功能障碍指数(ODI)及VAS评分。结果:术后复查见PVP组骨水泥弥散效果较PKP组好,术后随访发现PVP组病椎高度丢失率及Cobb角明显小于PKP组(P<0.05)。两组组内术后ODI及VAS评分较治疗前明显改善(P<0.05)。术后1 d PVP组ODI及VAS评分低于PKP组(P<0.05),但术后1,6,12个月随访两组ODI及VAS评分比较差异无统计学意义(P>0.05)。结论:PVP治疗骨质疏松性胸腰椎Ⅰ度压缩骨折,其骨水泥弥散效果优于使用PKP,早期能快速缓解疼痛,改善功能障碍,并减少远期发生椎体高度丢失的可能性。
Abstract:
Objective:To compare the therapeutic efficacy and complications of PVP and PKP for treating osteoporotic thoracolumbar vertebral compression fractures of I degree.Methods:Retrospective analyzed the clinical data of 63 cases with osteoporotic thoracolumbar compression fractures of I degree in our department.They were divided into PVP group(n=30)and PKP group(n=33)depending on the treatment method.The loss rate of vertebral height,the changes of Cobb angle,the preoperative and postoperative Oswestry disability index(ODI),and VAS score were observed and compared after bone cement dispersion within the fracture line.Results:The cement dispersion effect of PVP group was better than that of PKP group after review.The vertebral height and Cobb angle loss rate of PVP group was significantly less than PKP group(P<0.05).The ODI and VAS score of two groups were significantly improved after treatment(P<0.05).The ODI and VAS score of PVP group were lower than PKP group at 1st day after operation(P<0.05),but there were not statistically significant at 1st,6th,and 12th months after operation.Conclusion:PVP is effective for treating osteoporotic thoracolumbar vertebral compression fractures of I degree,which is superiority than PKP,with advantages of relieving pain quickly,improving dysfunction,and reducing the likelihood of long-term occurrence of vertebral height loss.

参考文献/References:

[1] 陈书连,张广泉,高坤,等.经皮椎体成形术与椎体后凸成形术治疗骨质疏松性椎体骨折的疗效比较研究[J].中华实用诊断与治疗杂志,2009,23(10):953-956.
[2] Coumans JV,Reirdmrdt MK,Lieberman IH.Kyphoplasty for vertebral compression fractures:1-year clinical outcomes from a prospective study [J].Neurosurg Spine,2003,99(1):44-50.
[3] 陈浩雄,赵亮,林松青.床托复位结合经皮椎体成形术治疗骨质疏松性胸腰椎压缩骨折[J].中国中医骨伤科杂志,2013,21(10):20-22.
[4] 孟祥玉,谢江,吐尔洪江.经皮椎体成形术治疗老年骨质疏松性压缩骨折新鲜性与陈旧性骨折的对比研究[J].新疆医学,2015,45(3):290-293.
[5] 杨明亮,洪毅,李建军,等.新鲜与陈旧骨质疏松性椎体骨折的鉴别诊断[J].中国矫形外科杂志,2008,16(12):897-899.
[6] 王振斌,涂来勇,卡哈尔·艾肯木,等.椎体骨折线内骨水泥弥散情况在经皮椎体成形中的作用[J].中国组织工程研究,2015,19(21):3281-3286.
[7] Phillips FM,Ho E,Campbell-Hupp M,et al.Early radiographic and clinical results of balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures [J].Spine,2003,28(19):2260-2265.
[8] 何保玉,刘宝戈,李学民,等.骨水泥弥散容积率在骨质疏松性椎体压缩骨折PKP术后疗效评价中的应用[J].中国骨与关节杂志,2016,5(1):68-73.
[9] Kado DM,Browner WS,Palermo L,et al.Vertebral fracture and mortality in older women:a prospective study [J].Arch Intern Med,1999,159(11):487-492.
[10] 江晓兵,莫凌,梁德,等.骨水泥在椎体骨折线内弥散情况对椎体成形术治疗效果的影响[J].中国脊柱脊髓杂志,2014,24(2):144-149.
[11] Tanigawa N,Komemushi A,kariya S,et al.Relationship between cement distribution pattern distribution pattern and new compression fracture after percutaneous vertebroplasty [J].Am J Roentgenol,2007,189(6):348-352.
[12] Hadjipavlou AG,Tzermiadianos MN,Katonis PG,et al.Percutaneous vertebroplasty and balloonkyphoplasty for the treatment of osteoporotic vertebral compression fracturesand osteolytictumours [J].J Bone Joint Surg Br,2005,87(12):1595-1604.
[13] EichlerK,Zangos S,Mack MG,et al.Outcome of long-axis percutaneous sacroplasty for the treatment of sacralinsufficiency fractures with a radiofrequency-induced,high-viscosity bone cement[J].Skeletal Radiol,2014,43(4):493-498.
[14] Chiu YC,Yang SC,Chen HS,et al.Clinical evaluation of repepercutaneous vertebroplasty for symptomatic cemented vertebrae[J].J Spinal Disord Tech,2012,25(8):E245-E253.

备注/Memo

备注/Memo:
基金项目:卫生部医药卫生科技发展研究中心科研基金 (W2014ZT210) 1甘肃省中医院(兰州,730050) 2甘肃中医药大学 △通信作者 E-mail:dengqiang11576@sohu.com
更新日期/Last Update: 2016-12-01