CAJ | 학술논문

目的探讨经皮椎体后凸成形术(PKP)治疗陈旧性骨质疏松椎体压缩性骨折(OVCF)的疗效. 方法回顾性分析2012年1月至2013年8月收治且符合纳入和排除标准的52例陈旧性OVCF患者资料,遵循患者意愿分别采用PKP治疗(PKP组,32例)和保守疗法(保守组,20例).两组患者术前基线一致,具有可比性.评估并比较两组患者治疗前1d、治疗后1d、1个月、3个月、6个月的疼痛视觉模拟评分(VAS)、生活质量评分(SF-36)及Oswestry功能障碍指数(ODI).比较PKP组手术前、后椎体中间高度及伤椎后凸cobb角. 结果所有患者治疗后获6～16个月(平均10个月)随访.与保守组比较,治疗后1d、1个月、3个月、6个月PKP组的VAS评分更低、SF-36评分更高、ODI更低,差异均有统计学意义(P＜0.05).PKP组术后1d、1个月、3个月、6个月的VAS评分、SF-36评分、ODI指数、椎体中间高度分别与术前1d比较均改善,差异有统计学意义(P＜0.05);但PKP组术后1d、1个月、3个月、6个月的后凸cobb角分别与术前1d比较,差异均无统计学意义(P＜0.05). 结论与保守疗法治疗陈旧性OVCF比较,PKP能够快速、有效地缓解腰背疼痛,可以增加椎体强度、恢复椎体部分高度、提高生活质量,值得施行.
목적 탐토경피추체후철성형술(PKP)치료진구성골질소송추체압축성골절(OVCF)적료효. 방법 회고성분석2012년1월지2013년8월수치차부합납입화배제표준적52례진구성OVCF환자자료,준순환자의원분별채용PKP치료(PKP조,32례)화보수요법(보수조,20례).량조환자술전기선일치,구유가비성.평고병비교량조환자치료전1d、치료후1d、1개월、3개월、6개월적동통시각모의평분(VAS)、생활질량평분(SF-36)급Oswestry공능장애지수(ODI).비교PKP조수술전、후추체중간고도급상추후철cobb각. 결과 소유환자치료후획6～16개월(평균10개월)수방.여보수조비교,치료후1d、1개월、3개월、6개월PKP조적VAS평분경저、SF-36평분경고、ODI경저,차이균유통계학의의(P＜0.05).PKP조술후1d、1개월、3개월、6개월적VAS평분、SF-36평분、ODI지수、추체중간고도분별여술전1d비교균개선,차이유통계학의의(P＜0.05);단PKP조술후1d、1개월、3개월、6개월적후철cobb각분별여술전1d비교,차이균무통계학의의(P＜0.05). 결론 여보수요법치료진구성OVCF비교,PKP능구쾌속、유효지완해요배동통,가이증가추체강도、회복추체부분고도、제고생활질량,치득시행.
Objective To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) for old osteoporosis vertebral compression fracture (OVCF).Methods From January 2012 to August 2013,52 patients with old OVCF were treated in our department.They were 11 males and 41 females.Of them,32 were treated with PKP and 20 with conservative therapy.The 2 groups were comparable in baseline characteristics.All the patients were assessed before treatment,1 day,1,3,and 6 months after treatment using visual analogue scale (VAS),short form-36 health survey (SF-36) and Oswestry disability index (ODI).The midline vertebral body height and local sagittal cobb' s angle were measured before and after operation in the PKP group.Results All the patients were followed up for 6 to 16 months (average,10 months).Compared with the conservative therapy group,the PKP group scored significantly lower in VAS and ODI but significantly higher in SF-36 (P ＜ 0.05).In the PKP group,the scores of VAS,SF-36 and ODI,and the midline vertebral body heights at 1 day,1,3,and 6 months after treatment were all significantly improved compared with those before treatment (P ＜ 0.05); however,there were no significant differences regarding sagittal cobb's angle between pretreatment and all time points posttreatment (P ＞ 0.05).Conclusion In treatment of old OVCF,PKP is preferable to conservative therapy because it can lead to quicker effective relief of pain,better restoration of vertebral body height,enhanced vertebral stability and improved quality of life.