3种方法治疗老年胸腰椎压缩性骨折的疗效比较

目的：比较经皮球囊扩张椎体后凸成形术、椎弓根螺钉内固定术及保守治疗对胸腰椎压缩性骨折的临床疗效。方法将92例胸腰椎压缩性骨折患者按治疗方法的不同分为3组：A 组26例，行经皮球囊扩张椎体后凸成形术；B 组35例，行椎弓根螺钉内固定术；C 组31例，行保守治疗。比较3组治疗前，治疗1周后和治疗1年后伤椎椎体前壁高度的压缩率、伤椎椎体后凸畸形角度的情况，并对3组治疗前，治疗1周后和治疗1年后疼痛情况进行评分采用视觉模拟评分（VAS）]。结果A 组治疗1周后 VAS 得分明显低于 B、C 组，C 组治疗1年后 VAS 得分明显高于 A、B 组，A、B 组治疗1周后伤椎椎体前壁高度的压缩率均明显低于 C 组，B、C 组治疗1年后伤椎椎体前壁高度的压缩率均明显高于 A 组，A、B 2组治疗1周后、治疗1年后伤椎椎体后凸畸形角度均较 C 组减少，A 组治疗1年后伤椎椎体后凸畸形角度较 B 组减少（均 P ＜0．05）。结论经皮球囊扩张椎体后凸成形术既能迅速缓解患者伤椎处疼痛，又能防止术后伤椎椎体高度和脊柱矫正角度的丢失，是一种治疗胸腰椎压缩性骨折的较理想方法。

Comparison of Three Different Methods for Thoracolumbar Compression Fractures in Elderly Patients

Objective To compare the clinical effects of percutaneous balloon kyphoplasty,ped-icle screw fixation and conservative therapy on thoracolumbar compression fractures in elderly pa-tients.Methods Ninety-two patients with thoracolumbar compression fractures were treated with percutaneous balloon kyphoplasty（group A,n= 26）,pedicle screw fixation（group B,n= 35）or conservative therapy（group C,n=31）.The compression rate of anterior wall height and the ky-phosis angle of the compressed vertebral body were observed and the visual analogue scale（VAS） was used for the assessment of pain intensity before and after treatment for 1 week and 1 year. Results After treatment for 1 week,VAS score in group A was lower than that in group B or C, compression rate of anterior wall height in group A or B was lower than that in group C,and ky-phosis angle in group A or B was smaller than that in group C（P 〈0.05）.After treatment for 1 year,VAS score in group C was significantly higher than that in group A or B,compression rate of anterior wall height in group B or C was lower than that in group A,kyphosis angle in group A or B was smaller than that in group C,and kyphosis angle in group A was smaller than that in group B（P 〈0.05）.Conclusion Percutaneous balloon kyphoplasty is an ideal treatment for quickly re-lieving the pain and preventing the loss of vertebral body height and kyphosis angle of the com-pressed vertebral body in elderly patients with thoracolumbar compression fractures.