CAJ | 학술논문

目的探讨经皮椎体成型术(PVP)治疗老年骨质疏松性上、中段胸椎压缩骨折的可行性及疗效. 方法本研究共纳入101患者,其中PVP治疗组(观察组)55例,保守治疗组(对照组)46例.通过治疗前后的视觉模拟疼痛评分(VAS)评分、Oswestry功能障碍指数(ODI)评分、椎体高度及Cobb角的变化来评价两种治疗方式的临床疗效. 结果手术后48 h及6周后,观察组VAS评分、ODI评分明显低于对照组(P＜0.05);治疗后6个月后,两组VAS评分、ODI评分差异无统计学意义(P＞0.05).治疗6个月后,对照组椎体前、中柱平均高度有不同程度下降,Cobb角增大;观察组则无明显变化,两组比较差异有统计学意义(P＜0.05). 结论 PVP治疗上、中段胸椎骨质疏松性骨折是一种安全有效的方法,近期、远期评价指标优于保守治疗.但PVP对于手术者专业技术水平及影像监视设备要求较高,并且存在一定的风险,建议在高清透视设备下进行,需谨慎对待.
목적 탐토경피추체성형술(PVP)치료노년골질소송성상、중단흉추압축골절적가행성급료효. 방법 본연구공납입101환자,기중PVP치료조(관찰조)55례,보수치료조(대조조)46례.통과치료전후적시각모의동통평분(VAS)평분、Oswestry공능장애지수(ODI)평분、추체고도급Cobb각적변화래평개량충치료방식적림상료효. 결과 수술후48 h급6주후,관찰조VAS평분、ODI평분명현저우대조조(P＜0.05);치료후6개월후,량조VAS평분、ODI평분차이무통계학의의(P＞0.05).치료6개월후,대조조추체전、중주평균고도유불동정도하강,Cobb각증대;관찰조칙무명현변화,량조비교차이유통계학의의(P＜0.05). 결론 PVP치료상、중단흉추골질소송성골절시일충안전유효적방법,근기、원기평개지표우우보수치료.단PVP대우수술자전업기술수평급영상감시설비요구교고,병차존재일정적풍험,건의재고청투시설비하진행,수근신대대.
Objective To discuss the feasibility and the effects of percutaneous vertebroplasty (PVP) in the treatment of the osteoporotic compression fracture in theupper and middle thoracic vertebrae.Methods The study included 101 patients.55 cases were treated with PVP (observation group) and 46 cases were treated with conservative treatment (control group).The clinical efficacy of those two different treatment methods was evaluated by the changes of VAS score,ODI score,vertebral height and Cobb angle before versus after treatment.Results VAS and ODI scores at 48 hours and 6 weeks after treatment was significantly lower in observation group than in the control group (all P＜0.05).Although there was no significant difference in VAS and ODI scores between the two groups after 6 months of treatment (both P＞0.05),the anterior and middle vertebral height was decreased and Cobb angle of spine was increased in control group as compared with observation group (both P＜ 0.05).Conclusions PVP is an effective and safe method in the treatment of osteoporotic vertebral compression fractures in upper and middle thoracic vertebrae.The short-and long-term evaluation indexes are better in PVP than in conservative treatment.But the surgery should be proceeded under highly clear perspective equipment by the surgeons with highly level professional technology.Because the surgery is highly risky,surgery should be proceeded with cautions.