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目的探讨经皮椎体后凸成形术(PKP)治疗老年骨质疏松性胸腰椎骨折不愈合的临床疗效。方法回顾性分析自2010-09—2015-09采用PKP治疗的骨质疏松性胸腰椎骨折不愈合48例。比较术前、术后及末次随访时椎体前缘高度、椎体后缘高度、局部后凸角及VAS评分。结果 48例均获得随访6~32个月,平均19.5个月。术后及末次随访时VAS评分、后凸角较术前明显减少,差异有统计学意义(P<0.05);但末次随访时与术后比较差异无统计学意义(P>0.05)。术后及末次随访时伤椎前缘高度较术前明显增高,差异有统计学意义(P<0.05);但末次随访时与术后比较差异无统计学意义(P>0.05)。术后、末次随访时伤椎后缘高度比较差异无统计学意义(P>0.05)。结论对于无椎管占位、脊髓神经损伤的骨质疏松性椎体骨折不愈合患者,PKP能立即缓解疼痛、恢复椎体高度、矫正后凸畸形,且创伤较小。
Objective To investigate the clinical efficacy of percutaneous kyphoplasty (PKP) in the treatment of senile osteoporotic thoracolumbar fractures. Methods A retrospective analysis of 48 cases of nonunion of osteoporotic thoracolumbar fractures treated with PKP from 2010-09-2015-09. The anterior vertebral height, posterior vertebral height, kyphosis and VAS score were compared before, during and at the last follow-up. Results All the 48 cases were followed up for 6 to 32 months with an average of 19.5 months. The VAS score and kyphotic angle of postoperative and final follow-up were significantly decreased compared with that before operation (P <0.05), but there was no significant difference between the last follow-up and postoperative (P> 0.05). The height of the injured vertebral anterior vertebrae at postoperative and final follow-up was significantly higher than that before operation (P <0.05), but there was no significant difference between the last follow-up and the postoperative follow-up (P> 0.05). There was no significant difference in the posterior margin of the injured vertebra after the last follow-up (P> 0.05). Conclusion For patients with vertebral nonunion and osteoporotic vertebral fractures without spinal canal injury, PKP can relieve pain immediately, restore vertebral height and correct kyphosis with less trauma.