Wang Xiao-Feng, Yang Yi-Yu, Yu Zhi-Hua, Li Chong-Qing, Wu Yin-Sheng
Department of Orthopaedics, Hospital of the Integration of Traditional Chinese and Western Medicine, Wenzhou 325000, Zhejiang, China.
Zhongguo Gu Shang. 2010 Oct;23(10):730-3.
To evaluate the clinical effects of percutaneous kyphoplasty (PKP) and conservative therapy in patients with osteoporotic vertebral compression fractures (OVCF).
The data of 63 patients with OVCF from Sep. 2007 to Apr. 2009 were retrospectively analyzed. There were 14 males and 49 females,ranging in age from 63 to 92 years, with an average of 73.4 years. Among them, 30 cases(38 vertebrae), 33 cases (35 vertebrae) were respectively treated with PKP, conservative therapy. The VAS score, the height of vertebral body and the neighboring vertebral fracture were observed during follow-up.
All the patients were followed up from 10 to 15 months with an average of 13.3 months. Pain relieved in 27 cases with PKP, and VAS scores decreased from 8.32 before treatment to 2.63 at the 1st week after treatment; VAS scores still remained under 2 at the later follow-up. VAS scores had not changed at the 1st week after conservative therapy. VAS scores with conservative therapy were higher than with PKP after 1, 3 months (P < 0.05), but after 6 months, there was no significant difference between conservative therapy and PKP (P > 0.05). The average height of vertebral body on the X-rays increased in 4.1 mm at the 1st week after treatment with PKP (P < 0.01) and unchanged posteriorly. The height of vertebral body had some improvement at 3, 6 months after conservative therapy, but the height of vertebral body with PKP was significantly higher than with conservative therapy (P < 0.01). New fractures occurred in 4 cases (5 vertebrae) with PKP, in 2 cases (2 vertebrae) with conservative therapy.
PKP is an effective method in treating osteoporotic vertebral compression fractures, which can relieve pain quickly, increase stability immediately, recover height of vertebral body, but maybe can increase the risk of new fracture. Conservative therapy is not without any merit, as long as systemic treatment can still make good prognosis.
评估经皮椎体后凸成形术（PKP）与保守治疗对骨质疏松性椎体压缩骨折（OVCF）患者的临床疗效。
回顾性分析2007年9月至2009年4月63例OVCF患者的资料。其中男性14例，女性49例，年龄63～92岁，平均73.4岁。其中30例（38个椎体）、33例（35个椎体）分别接受PKP、保守治疗。随访期间观察视觉模拟评分（VAS）、椎体高度及相邻椎体骨折情况。
所有患者随访10～15个月，平均13.3个月。PKP组27例疼痛缓解，VAS评分由治疗前的8.32降至治疗后第1周的2.63；后期随访VAS评分仍低于2分。保守治疗后第1周VAS评分无变化。保守治疗1、3个月后VAS评分高于PKP组（P<0.05），但6个月后保守治疗与PKP组差异无统计学意义（P>0.05）。PKP治疗后第1周X线片上椎体平均高度增加4.1mm（P<0.01），椎体后缘高度无变化。保守治疗后3、6个月椎体高度有一定改善，但PKP组椎体高度明显高于保守治疗组（P<0.01）。PKP组4例（5个椎体）、保守治疗组2例（2个椎体）发生新发骨折。
PKP是治疗骨质疏松性椎体压缩骨折的有效方法，能迅速缓解疼痛，即刻增加稳定性，恢复椎体高度，但可能增加新发骨折风险。保守治疗也有一定优点，只要进行系统治疗仍可取得较好预后。
