CAJ | 학술논문

目的探讨经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗伴椎体内真空征的骨质疏松性椎体骨折和塌陷的临床疗效. 方法回顾性分析2009年6月-2011年6月应用PKP治疗的31例伴椎体内真空征的骨质疏松性椎体骨折和塌陷患者的临床资料,分析本组患者的临床及影像学特点,通过测量术前、术后1周、术后3～6个月随访时骨折椎体高度变化,同时采用视觉模拟评分(visual analogue scale,VAS)和Oswestry功能障碍指数(Oswestry disability index,ODI)评价PKP的临床疗效. 结果 31例患者均顺利完成手术,术后24 h内患者腰背部疼痛均有明显缓解.术后1周和术后3～6个月随访时骨折椎体的高度分别为(17.2±4.2) mm、(16.8±5.1) mm,与术前(11.4±1.7)mm比较差异均有统计学意义(P＜0.01),两次随访差异无统计学意义(P＞0.05).术后1周VAS评分、ODI分别为(2.8±1.7)分、31.6±8.4,与术前(8.6±1.3)分、78.3±8.5比较差异均有统计学意义(P＜0.01),术后3～6个月随访VAS评分、ODI分别为(2.3±0.8)分、(23.7±2.3),与术前比较差异有统计学意义(P＜0.01),与术后1周比较差异无统计学意义(P＞0.05). 结论 PKP治疗伴椎体内真空征的骨质疏松性椎体骨折和塌陷患者,可有效缓解疼痛,恢复骨折椎高度,具有良好的临床效果.
목적 탐토경피추체후철성형술(percutaneous kyphoplasty,PKP)치료반추체내진공정적골질소송성추체골절화탑함적림상료효. 방법 회고성분석2009년6월-2011년6월응용PKP치료적31례반추체내진공정적골질소송성추체골절화탑함환자적림상자료,분석본조환자적림상급영상학특점,통과측량술전、술후1주、술후3～6개월수방시골절추체고도변화,동시채용시각모의평분(visual analogue scale,VAS)화Oswestry공능장애지수(Oswestry disability index,ODI)평개PKP적림상료효. 결과 31례환자균순리완성수술,술후24 h내환자요배부동통균유명현완해.술후1주화술후3～6개월수방시골절추체적고도분별위(17.2±4.2) mm、(16.8±5.1) mm,여술전(11.4±1.7)mm비교차이균유통계학의의(P＜0.01),량차수방차이무통계학의의(P＞0.05).술후1주VAS평분、ODI분별위(2.8±1.7)분、31.6±8.4,여술전(8.6±1.3)분、78.3±8.5비교차이균유통계학의의(P＜0.01),술후3～6개월수방VAS평분、ODI분별위(2.3±0.8)분、(23.7±2.3),여술전비교차이유통계학의의(P＜0.01),여술후1주비교차이무통계학의의(P＞0.05). 결론 PKP치료반추체내진공정적골질소송성추체골절화탑함환자,가유효완해동통,회복골절추고도,구유량호적림상효과.
Objective To investigate the clinical effect of percutaneous kyphoplasty (PKP) in treatment of osteoporotic vertebral fractures and collapse with intravertebral vacuum sign.Methods A retrospective study was conducted on the clinical and radiological data of 31 patients with osteoporotic vertebral fractures and collapse with intravertebral vacuum sign treated by PKP from June 2009 to June 2011.Vertebrae body variation,visual analog scale (VAS) and Oswestry disability index (ODI) before operation,during follow-up at postoperative one week and at postoperative 3-6 months were used as outcome measurements.Results All the patients went through operations successfully and presented significant mitigation of low back pain in 24 hours after operation.The vertebrae body height at postoperative one week [(17.2 ±4.2) mm] and at postoperative 3-6 months [(16.8 ±5.1)mm] were statistically different from that before operation [(11.4 ± 1.7) mm,P ＜0.01],while there was no statistical difference between the two follow-ups (P ＞ 0.05).VAS and ODI at postoperative one week [(2.8 ± 1.7) points and (31.6 ± 8.4) points] were statistically different from those before operation [(8.6 ± 1.3) points and (78.3 ±8.5) points,P＜0.01].VAS and ODI at postoperative 3-6 months [(2.3 ±0.8) points and (23.7 ± 2.3) points] presented statistical differences from those before operation (P ＜ 0.01),but no statistical differences from those at postoperative one week (P ＞ 0.05).Conclusion PKP obtains satisfactory clinical outcomes,for it relieves low back pain and restores vertebral body height.