CAJ | 학술논문

目的：比较经皮椎体后突成形术（PKP）与保守疗法治疗骨质疏松性椎体压缩性骨折的临床疗效。方法：2009年4月至2013年9月来我院诊治并符合骨质疏松骨折患者132例，根据患者对于治疗方法本人意愿，进行前瞻性分组。于治疗后l周和1、3、6、12个月时进行VAS和ODI评分，并进行组内和组间比较。结果：治疗后1周PKP组的VAS、ODI评分与治疗前比较明显降低(P<0．05)；保守治疗组治疗后1周VAS、ODI评分与治疗前比较无明显改善(P>0．05)，治疗后1个月后两组VAS、ODI评分与治疗前比较均明显降低(P<0．05)。PVP组治疗后1周和1、3、6、12个月时的VAS、ODI评分均优于保守组(P<0．05)。PKP组与保守治疗组患者在随访期内分别出现6例1节和4例1节新发椎体骨折。结论：PKP和保守方法治疗胸腰椎OVCF均有效．但和保守治疗方法相比，PKP可快速改善OVCF患者的疼痛及生活质量。
목적：비교경피추체후돌성형술（PKP）여보수요법치료골질소송성추체압축성골절적림상료효。방법：2009년4월지2013년9월래아원진치병부합골질소송골절환자132례，근거환자대우치료방법본인의원，진행전첨성분조。우치료후l주화1、3、6、12개월시진행VAS화ODI평분，병진행조내화조간비교。결과：치료후1주PKP조적VAS、ODI평분여치료전비교명현강저(P<0．05)；보수치료조치료후1주VAS、ODI평분여치료전비교무명현개선(P>0．05)，치료후1개월후량조VAS、ODI평분여치료전비교균명현강저(P<0．05)。PVP조치료후1주화1、3、6、12개월시적VAS、ODI평분균우우보수조(P<0．05)。PKP조여보수치료조환자재수방기내분별출현6례1절화4례1절신발추체골절。결론：PKP화보수방법치료흉요추OVCF균유효．단화보수치료방법상비，PKP가쾌속개선OVCF환자적동통급생활질량。
Objectives:To compare the clinical outcome of painful osteoporotic vertebral compression fractures(OVCF)treated by percutaneous kyphoplasty(PKP)and conservative treatment. Methods:132 consecutive patients aged 55 years or older from April 2009 to September 2013 in our hospital were enrol ed in this study. Al patients ’suffered from vertebral Compression fracture evidenced bone on MRI.and the VAS score was≥6 and lasted for 8 weeks or less,The exclusion criteria included other unclear spinal disorders,history of stroke,metastatic spinal tumor ,infection,residual vertebral height more than 75%and noncorrectable coagulopathy.Patients were al ocated to PKP group(n=74)or conservative treatment group(n=58)according to patients’ desire.VAS for pain and Oswestry disability index(ODI)questionnaire scores were assessed and Compared before treatment and at 1week,1,3,6,1 2 and 24 months after treatment.The patient age,sex,body weight,duration of OVCF,the loss of vertebral height,,number of OVCF,VAS and ODI scores between the two groups were documented and compared.Results:.VAS and ODI scores decreased significantly(P<0.05) in PKP at 1 week,but those in conservative group Decreased significantly at 1 month after treatment.VAS and ODI score decreased more significantly in PKP group at 1week and at 1,3,6 and 12 months Compared with conservative group(P<0.05). Six patients in PKP group and four patients in conservative group had one vertebral fracture respectively.Conclusions: Both PKP and conservative treatment are effective for the painful osteoporotic thoracolumbar OVCF.PKP has immediate pain relief and functional improvement compared with conservative treatment.