新鲜椎体骨折早期成型术对减少邻近椎体再骨折疗效分析.docVIP

新鲜椎体骨折早期成型术对减少邻近椎体再骨折疗效分析 　　[摘要] 目的 回顾分析新鲜、陈旧骨质疏松性椎体骨折行经皮椎体成型术或保守治疗术对发生邻近椎体骨折的影响，寻找减少邻近椎体骨折的方法。 方法 回顾我科2012年9月～2014年12月骨质疏松性椎体压缩性骨折患者114例，分为三组，其中新鲜骨折（A组）38例、陈旧性骨折（B组）38例、保守治疗组（C组）38例。对三组患者的疼痛VAS评分、椎体高度变化情况、后凸角度变化纠正情况及发生邻近椎体骨折的数量进行比较。 结果 所有患者均随访超过12个月。A组术前VAS评分（8.4±1.3）分，术后12个月（1.5±0.5）分，B组术前（5.8±1.4）分，术后12个月（7.3±2.0）分，C组术前（5.8±1.4）分，术后12个月（5.2±1.0）分，三组间比较差异均有统计学意义（P0.05）。邻椎骨折：A 组 3例；B 组12 例，C 组邻椎骨折 6 例，三组间比较差异有统计学意义（P0.05）。 结论 新鲜骨折早期椎体成型能减少邻近椎体再骨折。 　　[关键词] 椎体压缩性骨折；经皮椎体成型术；新鲜骨折；陈旧性骨折；邻近椎体骨折 　　[中图分类号] R687.3 [文献标识码] B [文章编号] 1673-9701（2016）14-0059-04 　　[Abstract] Objective To retrospectively compare the risk of new fracture in adjacent vertebral body after percutaneous vertebroplasty and conservation in the treatment of acute and chronic osteoporotic vertebral compression fractures. Methods From September 2012 to December 2014， 114 cases for osteoporotic vertebral compression fractures were divided into three groups. Group A， 38 cases with acute fractures. Group B， 38 cases with chronic fractures. Group C， 38 cases with conservative treatment. The VAS score， vertebral body height， cobb angle， and the number of new fracture in adjacent vertebral body were compared among the three groups. Results All patients were followed up for 12 months. VAS score of group A before operation was （8.4±1.4）scores，after 12 months was （1.5±0.5） scores. VAS score of group B before operation was（5.8±1.4）scores， after 12 months was （7.3±2.0） scores， VAS score of group C before operation was（5.8±1.4）scores， after 12 months was （5.2±1.0） scores， the difference was statistically significant（P0.05）. Comparing the height of vertebral body and cobb angle， the difference was statistically significant in group A（P0.05）， and was not statistically significant in group B and C（P0.05）. New fracture of adjacent vertebral body happened in 3 patients in group A， 12 patients in group B and 6 patients in group C，the difference was statistically significant（P0.05）. Conclusion Acute vertebral compression