PVP充填自固化磷酸钙骨水泥对老年疼痛性骨质疏松性胸腰椎骨折疼痛及生活质量的影响

doi:10.3969/j.issn.10056483.2019.03.021

摘要/Abstract

摘要： 目的:探讨经皮椎体成形术（PVP）充填自固化磷酸钙骨水泥（CPC）对老年疼痛性骨质疏松性腰椎骨折（OVCF）病人疼痛及生活质量的影响。方法:老年疼痛性OVCF病人127例，随机分为两组：A组65例，采用CPC及PVP系统治疗，B组62例，采用聚甲基丙烯酸甲酯骨水泥（PMMA）及PVP系统治疗。比较两组术后并发症，评价Oswestry功能障碍指数（ODI）、疼痛视觉模拟量表（VAS）评分、国际骨质疏松生活质量评估量表41（QUALEFFO41）评分，影像学检查椎体形态改变。结果:术后3天、1个月、3个月、6个月及末次随访12个月，两组VAS评分均较术前显著降低（P<0.05），但A组和B组间比较差异无统计学意义（P>0.05）。两组术后1个月、6个月及末次随访时ODI及QUALEFFO41评分均较术前显著降低（P<0.05），A组术后6个月及末次随访时评分低于B组（P<0.05）。术后两组压缩椎体前缘高度均提高，后凸Cobb角明显降低（P<0.05），但两组间比较差异无统计学意义（P>0.05）。两组骨水泥渗漏率比较差异无统计学意义（P>0.05）；A组邻近椎体骨折率为1.54%，显著低于B组的9.68%（P<0.05）。结论:PVP充填CPC能够有效缓解老年疼痛性胸腰椎OVCF病人的疼痛症状，改善椎体畸形，促进功能康复活并提高其生活质量。

关键词: 骨质疏松性胸腰椎骨折, 经皮椎体成形术, 磷酸钙骨水泥, 疼痛

Abstract: Objective:To investigate the effect of percutaneous vertebroplasty（PVP）with selfcuring calcium phosphate cement（CPC）on pain and quality of life in elderly patients with painful osteoporotic lumbar fractures（OVCF）.Methods:127 cases of elderly patients with painful thoracolumbar OVCF were randomly divided into two groups：group A（n=65）was treated with CPC and PVP system，group B（n=62）was treated with polymethyl methacrylate（PMMA）and PVP system.The postoperative complications were compared.The Oswestry Disability Index（ODI），pain Visual Analogue Scale（VAS），Qualitative Quality of Life Assessment 41（QUALEFFO41）scores were evaluated before and after surgery，the vertebral morphology was determined and compared.Results:At 3 days，1 month，3 months，6 months and 12 months' final followup，the VAS scores of both groups were significantly lower than before surgery（P<0.05），but there was no significant difference between group A and group B（P>0.05）.ODI and QUALEFFO41 scores at 1 month，6 months and final followup in the two groups were significantly lower than before surgery（P<0.05），the scores of group A were lower than group B at 6 months the final followup（P<0.05）.The anterior height of compressed vertebral body in both groups was significantly increased after surgery，and the Cobb angle of kyphosis was significantly decreased（P<0.05），but there was no significant difference between the two groups（P>0.05）.There was no significant difference in the leakage rate of bone cement between the two groups（P>0.05）.The fracture rate in the adjacent vertebral body in group A was 1.54%，significantly lower than 9.68% in group B（P<0.05）.Conclusion:PVP filling with CPC can effectively relieve the pain symptoms of elderly patients with painful thoracolumbar OVCF，improve vertebral body deformity，promote functional rehabilitation and improve their quality of life.

Key words: osteoporotic thoracolumbar fractures, percutaneous vertebroplasty, calcium phosphate cement, pain

余智, 韩森东. PVP充填自固化磷酸钙骨水泥对老年疼痛性骨质疏松性胸腰椎骨折疼痛及生活质量的影响[J]. 临床外科杂志, 2019, 27(3): 243-246.

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