高级检索

经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的效果

孙义军, 孙晴, 龚福太

孙义军, 孙晴, 龚福太. 经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的效果[J]. 实用临床医药杂志, 2020, 24(23): 45-48. DOI: 10.7619/jcmp.202023015
引用本文: 孙义军, 孙晴, 龚福太. 经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的效果[J]. 实用临床医药杂志, 2020, 24(23): 45-48. DOI: 10.7619/jcmp.202023015
shu
SUN Yijun, SUN Qing, GONG Futai. Effect of percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures[J]. Journal of Clinical Medicine in Practice, 2020, 24(23): 45-48. DOI: 10.7619/jcmp.202023015
Citation: SUN Yijun, SUN Qing, GONG Futai. Effect of percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures[J]. Journal of Clinical Medicine in Practice, 2020, 24(23): 45-48. DOI: 10.7619/jcmp.202023015
shu

经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的效果

  • 陕西省西安市中医医院 骨伤科脊柱病区, 陕西 西安, 710021

基金项目: 

陕西省科技厅基金项目(2016JM02155)

详细信息

  • 中图分类号: R683.2;R681.5

Effect of percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures

  • Spine Ward in Department of Orthopedics, Xi'an City Hospital of Traditional Chinese Medicine in Shaanxi Province, Xi'an, Shaanxi, 710021

摘要

    摘要
  • 摘要: 目的 观察经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)的临床效果。 方法 回顾性分析126例OVCF患者的临床资料,将采用PKP治疗的69例患者纳入PKP组,将采用经皮椎体成形术(PVP)治疗的57例患者纳入PVP组。观察2组的手术情况和术后并发症发生情况,并比较2组伤椎矫治情况(伤椎前缘高度、椎体压缩率、Cobb角)及不同时点的疼痛程度［视觉模拟评分法(VAS)评分］、椎体功能［Oswestry功能障碍指数(ODI)评分］变化。 结果 PKP组手术时间长于PVP组,透视次数及骨水泥用量多于PVP组,差异有统计学意义(P<0.05); 2组出血量比较,差异无统计学意义(P>0.05)。术后6个月时, 2组伤椎前缘高度均大于术前,且PKP组大于PVP组,差异有统计学意义(P<0.05); 2组椎体压缩率、Cobb角低于术前,且PKP组低于PVP组,差异有统计学意义(P<0.05)。术后, 2组VAS评分均逐渐降低,组内差异有统计学意义(P<0.05); 术前、术后3 d时, 2组间VAS评分比较,差异无统计学意义(P>0.05); 术后6个月时, PKP组VAS评分低于PVP组,差异有统计学意义(P<0.05)。术后, 2组ODI评分均逐渐降低,组内差异有统计学意义(P<0.05); 术前、术后1周及术后6个月时, 2组间ODI评分比较,差异均无统计学意义(P>0.05)。PKP组总并发症发生率低于PVP组,差异有统计学意义(P<0.05)。 结论 PKP与PVP在改善OVCF患者椎体功能方面效果相当, PVP手术时间更短、术中透视次数更少,而PKP在矫治伤椎畸形、缓解疼痛和提升治疗安全性方面更具优势。
    Abstract: Objective To observe the clinical effects of percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF). Methods The clinical data of 126 patients with OVCF was retrospectively analyzed. Sixty-nine patients treated with PKP were included in the PKP group, and 57 patients treated with percutaneous vertebroplasty(PVP)were included in the PVP group. The operative situation and postoperative complications of the two groups were observed, and the changes of the injured vertebral correction(anterior edge height, vertebral compression rate, Cobb angle), pain degree ［Visual Analogue Scale(VAS)score］ and vertebral function ［Oswestry Disability Index(ODI)score］ of the two groups were compared. Results The operative time in the PKP group was shorter, fluoroscopy frequency and bone cement amount were greater than those in the PVP group(P<0.05). There was no significant difference in bleeding amount between the two groups(P>0.05). At 6 months after operation, the anterior height of injured vertebrae in the two groups was increased compared with that before operation, and the height in the PKP group was larger than that in PVP group(P<0.05). The vertebral compression rates were lower and Cobb angles were smaller in the two groups than those before operation, and the above indexes in the PKP group were lower than those in the PVP group(P<0.05). After surgery, VAS scores in both groups gradually decreased, and the intra-group difference was statistically significant(P<0.05). VAS scores before surgery and 3 days after surgery between the two groups showed no significant- differences(P>0.05). At 6 months after surgery, VAS score in the PKP group was significantly lower than that in the PVP group(P<0.05). After operation, ODI scores in both groups gradually decreased, and the intra-group difference was statistically significant(P<0.05). There were no significant differences in ODI scores between the two groups before surgery, 1 week and 6 months after surgery(P>0.05). The total incidence rate of complications in the PKP group was significantly lower than that in the PVP group(P<0.05). Conclusion PKP and PVP for OVCF have similar effects in improving the vertebral body function of patients. PVP has shorter operative time and less intraoperative fluoroscopy frequency. PKP is more advantageous in correcting the deformity of injured vertebrae, relieving the pain and improving the safety of treatment.
    • HTML全文
    • 参考文献(16)
  • 沈煜, 冯明利, 徐军, 等. 老年骨质疏松性椎体压缩性骨折部位和腰椎骨密度对下腰部疼痛的影响[J]. 中华医学杂志, 2016, 96(23): 1818-1820.
    刘建文, 李明, 杨敏. 经皮椎体成形术改善保守治疗效果不佳的老年OVCF患者疼痛和功能障碍的效果观察[J]. 实用医院临床杂志, 2019, 16(2): 11-14.

    OKAZAKI T, NAKAGAWA H, YAGI K, et al. Bone scintigraphy for the diagnosis of the responsible level of osteoporotic vertebral compression fractures in percutaneous balloon kyphoplasty[J]. Clin Neurol Neurosurg, 2017, 152(4): 23-27.
    张作记. 行为医学量表手册[M]. 北京: 中华医学电子音像出版社, 2005: 485-487.
    俞红, 白跃宏. 简式中文版Oswestry功能障碍指数评定下背痛患者的信度及效度分析[J]. 中华物理医学与康复杂志, 2010, 32(2): 125-127.

    MATTEI T A. The specificity of SPECT-CT for the diagnosis of discogenic pain: implications for the future of the lumbar fusion outcome score(LUFOS)[J]. Spine J, 2018, 18(9): 1722-1724.
    潘朝国, 王帅, 谭意. 滋肾续骨汤联合经皮椎体成形术治疗老年椎体压缩性骨折临床疗效观察[J]. 实用医院临床杂志, 2018, 15(4): 214-217.
    温晓阳, 余凯龙, 何东生, 等. PKP与PVP治疗陈旧性骨质疏松性椎体压缩性骨折效果对比观察[J]. 山东医药, 2016, 56(42): 59-61.
    孙浩林, 李淳德, 朱佳琳, 等. PVP或PKP治疗激素诱导骨质疏松性椎体压缩骨折的临床研究[J]. 北京大学学报: 医学版, 2015, 47(2): 242-247.
    杭海峰, 汤新兵, 于健. 高粘度联合夯实技术在PKP治疗骨质疏松性椎体压缩性骨折中的临床效果观察[J]. 实用临床医药杂志, 2018, 22(7): 93-95.

    KATO S, HOZUMI T, YAMAKAWA K, et al. META: an MRI-based scoring system differentiating metastatic from osteoporotic vertebral fractures[J]. Spine J, 2015, 15(7): 1563-1570.
    左华, 黄永辉, 李大鹏, 等. 经皮椎体成形术及经皮后凸成形术治疗老年骨质疏松性椎体压缩性骨折的长期临床疗效比较[J]. 中国矫形外科杂志, 2015, 23(22): 2021-2025.
    董继胜, 董力军, 闫兵勇, 等. 经皮椎体成形术和经皮椎体后凸成形术治疗老年骨质疏松椎体压缩性骨折的疗效观察[J]. 中国矫形外科杂志, 2015, 23(8): 748-751.

    DIMOPOULOS M A, HILLENGASS J, USMANI S, et al. Role of magnetic resonance imaging in the management of patients with multiple myeloma: a consensus statement[J]. J Clin Oncol, 2015, 33(6): 657-664.
    马俊. 经皮椎体后凸成形术与经皮椎体成形术治疗骨质疏松椎体压缩骨折的疗效比较[J]. 中国矫形外科杂志, 2017, 25(6): 571-573.
    王福兵, 张夏琦, 彭庆辉, 等. 椎体成形术与椎体后凸成形术治疗老年骨质疏松性单椎体压缩骨折的疗效比较[J]. 实用临床医药杂志, 2018, 22(21): 86-89.
    • 相关文章
    • 施引文献(16)

  • 期刊类型引用(13)

    1. 刘愉勤，刘英，李兰，张滔，罗晓玲. 骨质疏松椎体骨折磁共振STIR信号改变与CT骨折线类型的关系. 实用临床医药杂志. 2024(05): 21-24 . 本站查看
    2. 张书涛. 经皮椎体成形术治疗OVCF合并后凸畸形的临床研究. 实用中西医结合临床. 2024(13): 60-62+116 . 百度学术
    3. 谷同同，张彩宁，郑义朋. Sky骨扩张经皮椎体后凸成形术与球囊多点扩张经皮椎体后凸成形术治疗胸腰椎压缩性骨折的疗效比较. 中国临床医生杂志. 2024(11): 1353-1356 . 百度学术
    4. 赵中男，刘亚明，陈丽娟，彭拓奇，焦岩，王岐，王莹. 经皮椎体支架成形术与经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折疗效比较. 临床军医杂志. 2023(03): 318-320 . 百度学术
    5. 王伍贵. PKP、PVP分别联合骨折复位器治疗OVCF对患者伤椎形态及腰背功能的影响比较. 基层医学论坛. 2023(08): 38-40 . 百度学术
    6. 于泊，王建博，任宝，曹天威，黄卓，张利文. PCK对老年骨质疏松性椎体压缩骨折的疗效及对术后并发症、生活质量的影响. 广东医学. 2023(05): 584-590 . 百度学术
    7. 顾军，王睿，陆万里，周飞. 经皮椎体后凸成形术治疗椎体压缩性骨折瘦素、脂联素及CTX-Ⅰ水平分析. 分子诊断与治疗杂志. 2023(11): 1859-1863 . 百度学术
    8. 范水成. 右美托咪定对经皮椎体成形术患者镇静效果及血流动力学的影响. 数理医药学杂志. 2022(01): 67-69 . 百度学术
    9. 高铭. 经皮椎体后凸成形术在骨质疏松性椎体压缩骨折治疗中的应用效果观察. 中国现代药物应用. 2022(03): 57-60 . 百度学术
    10. 宋体忠. PVP与PKP治疗骨质疏松性胸腰椎压缩骨折临床效果对比. 系统医学. 2022(05): 95-98 . 百度学术
    11. 刘庆佳. 骨填充网袋椎体成形术与经皮球囊后凸成形术治疗骨质疏松性椎体压缩性骨折患者的效果比较. 中国民康医学. 2021(09): 123-125 . 百度学术
    12. 崔峰，赵志坚，史君，丁丁. 经皮球囊后凸成形术治疗类风湿关节炎合并骨质疏松性椎体压缩骨折的影像学和临床效果. 临床医学工程. 2021(10): 1301-1302 . 百度学术
    13. 刘海鹏，罗唯师，杨炎彬. 温针灸结合补阳还五汤口服治疗骨质疏松性椎体压缩骨折经皮椎体后凸成形术后残留痛的临床疗效及安全性分析. 医学食疗与健康. 2021(10): 26-27 . 百度学术

    其他类型引用(3)

    • 资源附件(0)
计量
  • 文章访问数:  240
  • HTML全文浏览量:  54
  • PDF下载量:  10
  • 被引次数: 16
出版历程
  • 收稿日期:  2020-10-09
  • 网络出版日期:  2020-12-20

目录

摘要
HTML全文
    参考文献(16)
    相关文章
    施引文献
    资源附件(0)

    /

    返回文章
    返回

    © 2020 《实用临床医药杂志》编辑部

    地址：江苏省扬州市江阳中路136号，扬州大学江阳路北校区14号楼201室邮编：225009电话：0514-87978917、87978989、87978807

    苏公网安备 32100302010246号

    本系统由 北京仁和汇智信息技术有限公司 开发  百度统计

    x 关闭 永久关闭