PVP、PKP、骨填充网袋治疗胸腰段骨质疏松性椎体压缩性骨折的疗效分析

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摘要目的对比分析经皮椎体成形术(percutaneous vertebroplasty，PVP)、经皮椎体后凸成形术(percutaneous kyphoplasty，PKP)、骨填充网袋(bone filling mesh container，BFMCs)治疗胸腰段骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture，OVCF)的临床效果，选择最优手术方式，更好地提升胸腰段骨质疏松性椎体压缩性骨折的治疗效果。方法结合临床实践，选取2013年5月至2017年4月因胸腰段骨质疏松性椎体压缩性骨折在我院接受PVP、PKP、BFMCs治疗的患者114例，共114个椎体，其中T₁₁ 椎体14个，T₁₂ 椎体35个，L₁椎体30个，L₂椎体15个，L₃椎体20个，分别记录三组手术后及术后1个月视觉模拟评分(visual analogue scale，VAS)、术后伤椎后凸角、椎体前柱高度。结果 PVP、PKP、BFMCs组在术后VAS评分较术前降低，其中PVP、PKP术后VAS评分均低于BFMCs，三组间差异有统计学意义(P＜0.05)，术后1个月随访VAS评分三组间比较，差异无统计学意义(P＞0.05)；PKP组和BFMCs组在术后伤椎后凸角、伤椎前柱高度恢复方面优于PVP组，但PKP组和BFMCs组间比较差异无统计学意义(P＞0.05)；在骨水泥渗漏方面：BFMCs组发生率低于PVP组、PKP组。结论 PVP、PKP、BFMCs三种手术方式治疗胸腰段骨质疏松性椎体压缩性骨折均取得了满意的临床效果；而BFMCs在治疗骨质疏松性椎体压缩性骨折中未发生骨水泥渗漏，为治疗骨质疏松性椎体压缩性骨折提供了一种安全的手术方式。

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	高志祥
	李淳
	李磊
	黄卫民

关键词 ：椎体成形术, 椎体后凸成形术, 骨填充网袋, 椎体压缩性骨折

Abstract：Objective To compare percutaneous vertebroplasty (PVP) and balloon kyphoplasty (PKP)，bone filling mesh container(BFMCs)in the treatment of thoracolumbar osteoporotic vertebral compression fractures (OVCFs)，and clinical effect；To select the best surgical approach to improve the treatment of thoracolumbar osteoporotic vertebral compression fractures.Methods 114 cases of thoracolumbar osteoporotic vertebral compression fractures were treated with PVP，PKP and BFMCs in our hospital from May 2013 to April 2017，with a total of 114 cases，among them：T₁₁ 14，T₁₂ 35，L₁ 30，L₂ 15，L₃ 20，the three groups were recorded after surgery and surgery after January VAS，postoperative vertebral kyphotic angle、anterior vertebral height.Results Three kinds of surgical methods in the postoperative visual analogue scale VAS score lower than the preoperative .The PVP and PKP postoperative VAS score was lower than that of BFMCs，a significant difference between the three groups (P＜0.05)，after January the followup of VAS score no significant difference between the three groups (P＞0.05)；PKP and BFMCs in the postoperative vertebral kyphotic angle，vertebral height restoration of anterior vertebral is better than PVP，but PKP and BFMCs had no significant difference between the three groups (P＞0.05)；In the bone cement leakage：the incidence of BFMCs group was lower than that of group PVP and group PKP.Conclusion PVP，PKP，BFMCs in the treatment of thoracolumbar osteoporotic vertebral compression fractures were satisfied with the clinical effect；BFMCs did not cause bone cement leakage in the treatment of osteoporotic vertebral compression fractures，So BFMCs is a safe surgical procedure in the treatment of cortical bone defects.

Key words： vertebroplasty kyphoplasty bone filling mesh container vertebral compression fractures

通讯作者: 黄卫民

作者简介: 高志祥(1991－ )，男，研究生在读，新疆医科大学第六附属医院脊柱外科，830002。

引用本文:

高志祥，李淳，李磊，黄卫民. PVP、PKP、骨填充网袋治疗胸腰段骨质疏松性椎体压缩性骨折的疗效分析[J]. 实用骨科杂志, 2017, 23(8): 680-697.
Gao Zhixiang，Li Chun，Li Lei，et al. Analysis of Curative Effect for PVP、PKP、Bone Filling Mesh Container in Treatment of Osteoporotic Thoracolumbar Vertebral Compression Fractures. sygkzz, 2017, 23(8): 680-697.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2017/V23/I8/680

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