梁智林 杨波 臧传义

【摘要】 目的：評价比较应用PVP（经皮椎体成形术）与PKP（经皮椎体后凸成形术）治疗骨质疏松性腰椎压缩骨折的效果。方法：选取本院2017年1月-2018年3月收治的骨质疏松性腰椎压缩骨折患者50例为研究对象，按照随机数字表法将其分为A组和B组，各25例。A组应用PKP治疗，B组应用PVP治疗，观察比较两组手术指标及治疗前后椎体前缘高度、Cobb角、ODI和VAS评分。结果：B组手术及住院时间均明显短于A组，差异均有统计学意义（P<0.05）；但两组骨水泥注射量比较，差异无统计学意义（P>0.05）。两组治疗前后的椎体前缘高度、Cobb角、ODI和VAS评分比较，差异均无统计学意义（P>0.05）；而治疗后，两组椎体前缘高度、Cobb角、ODI、VAS评分均较治疗前明显改善，且A组椎体前缘高度明显高于B组，差异均有统计学意义（P<0.05）。结论：应用PKP与PVP治疗骨质疏松性腰椎压缩骨折的效果均较为显著，前者可有效纠正后凸畸形，并恢复病椎高度；后者疗效确切、操作简单，两者各有优势，因此临床需根据患者具体情况合理选择，以提升临床疗效。

【关键词】 骨质疏松性； 腰椎压缩骨折； PKP； PVP

【Abstract】 Objective：To evaluate and compare the effect of PVP percutaneous vertebroplasty （PVP） and percutaneous kyphoplasty （PKP） in the treatment of osteoporotic lumbar vertebral compression fractures.

Method：A total of 50 patients with osteoporotic lumbar vertebral compression fractures treated in our hospital from January 2017 March 2018 were selected as the study objects.According to the random number table method，they were divided into group A and group B，25 cases in each group.Group A was treated with PKP treatment，group B was treated with PVP treatment.The operative indexes and anterior vertebral body height，Cobb angle，ODI and VAS scores before and after treatment between the two groups were observed and compared.Result：The operation and hospitalization time in group B were significantly shorter than those in group A，the differences were statistically significant （P<0.05）；but there was no significant difference in the amount of bone cement injection between the two groups （P>0.05）.There were no significant differences in the anterior vertebral body height，Cobb angle，ODI and VAS scores between the two groups before and after treatment （P>0.05）.After treatment，the anterior vertebral body height，Cobb angle，ODI and VAS scores of the two groups were significantly improved，and the anterior vertebral body height of group A was significantly higher than that of group B，the differences were statistically significant （P<0.05）.Conclusion：The effects of PKP and PVP in the treatment of osteoporotic lumbar vertebral compression fractures are significant.The former can effectively correct kyphosis deformity and restore the height of the vertebral lesions；the latter has definite curative effect and simple operation.Both have their own advantages，so the clinical needs to be reasonably selected according to the specific circumstances of patients to enhance clinical efficacy.

【Key words】 Osteoporosis； Lumbar vertebral compression fracture； PKP； PVP

First-authors address：Beijing Geriatric Hospital，Beijing 100095，China

doi：10.3969/j.issn.1674-4985.2018.31.034

在临床脊柱外科中，腰椎压缩骨折是一种常见损伤，针对此类患者，临床主要治疗方法为保守治疗，即支具+止痛+非手术联合治疗，但难以达到理想疗效[1-3]。而近几年由于微创技术的飞速发展，PVP（经皮椎体成形术）、PKP（经皮椎体后凸成形术）等获得了广泛应用，其优势在于恢复快、创伤小、操作简单、缓解疼痛、稳定骨折等[4-6]。本文即对应用PKP与PVP治疗骨质疏松性腰椎压缩骨折的效果进行了评价比较，现报道如下。

1 资料与方法

1.1 一般资料 选取本院2017年1月-2018年

3月收治的骨质疏松性腰椎压缩骨折患者50例为研究对象，纳入标准：均符合骨质疏松性腰椎压缩骨折的诊断标准；均经X线片、CT、MRI检查等确诊；均意识清晰。排除标准：合并严重肝、肾功能障碍；恶性肿瘤；精……