目的:本研究旨在评价经皮椎体后凸成形术(PKP)后不同椎体高度恢复率治疗骨质疏松性椎体压缩骨折(OVCF)的临床效果。
方法:根据PKP术后椎体前缘骨折的高度恢复率,采用X线影像将患者分为两组。A组低于80%,B组80%以上。临床术前和术后疗效(第1天,第一个月,第六个月,术后12个月)根据VAS进行评估,Oswestry残疾指数(ODI),欧洲骨质疏松基金会(QUALEFFO)的生活质量问卷,背痛生活障碍问卷(RQD)。同时,计算并分析两组患者术前、术后局部Cobb角及伤椎变化情况。
结果:A组术后Cobb角明显高于B组,B组的矫正率明显优于A组。ODI,QUALEFFO,各随访时间点B组患者的RQD评分均显著低于A组患者。椎体高度恢复率与VAS的相关系数,ODI,QUALEFFO,末次随访时RQD评分为-0.607(P<0.01),-0.625(P<0.01),-0.696(P<0.01),和-0.662(P<0.01),分别。
结论:椎体高度恢复率与上述临床疗效评分的相关性分析结果表明,提高椎体前高度恢复率有利于缓解疼痛,提高患者临床疗效。同时,提高椎体前缘高度恢复率,恢复正常的脊柱结构,有利于降低相邻椎体再骨折的发生率。
OBJECTIVE: This study aimed to evaluate the clinical effect of different vertebral body heights restoration rate after percutaneous kyphoplasty (PKP) for the treatment of osteoporotic vertebral compression fractures (OVCF).
METHODS: The patients were divided into two groups according to the height restoration rate of the anterior edge of the vertebral body fracture after PKP operation using X-Ray imaging. The group A was below 80%, and the group B was above 80%. Clinical preoperative and postoperative efficacy (1st day, 1st month, 6th month, and 12th month after surgery) were evaluated according to VAS, Oswestry Disability Index(ODI), Quality of Life Questionnaire of the European Foundation for Osteoporosis(QUALEFFO), and Back Pain Life Disorder Questionnaire(RQD). Simultaneously, the preoperative and postoperative local Cobb angles and changes in the injured vertebrae in the two groups were calculated and analyzed.
RESULTS: The postoperative Cobb angle in group A was significantly higher than that in group B. The correction rate in group B was significantly better than that in group A. The VAS, ODI, QUALEFFO, and RQD scores of group B patients were significantly lower than those of patients in group A at each follow-up time point. The correlation coefficients of vertebral body height restoration rate and VAS, ODI, QUALEFFO, and RQD scores at the last follow-up were - 0.607 (P < 0.01), -0.625 (P < 0.01), -0.696 (P < 0.01), and - 0.662 (P < 0.01), respectively.
CONCLUSIONS: The results of the correlation analysis between the vertebral body height restoration rate and the above clinical efficacy scores show that increasing the vertebral body anterior height restoration rate is beneficial for pain relief and improves the clinical efficacy of patients. Simultaneously, improving the height restoration rate of the anterior edge of the vertebral body and restoring the normal spinal structure is beneficial for reducing the incidence of refracture of the adjacent vertebral body.