PKP治疗老年骨质疏松椎体骨折思路探索张沿洲1柳海铭1刘政1胡举1尹毅2(通讯作者)(1.昆山市第四人民医院骨科江苏昆山215331；2.昆山市第一人民医院脊椎科江苏昆山215300)【摘要】目的：探讨经皮椎体后凸成形术(PKP)治疗老年骨质疏松椎体骨折的临床疗效及安全性，为提高老年骨质疏松致骨折患者整体手术疗效提供思路。方法：回顾性分析2012年9月至2014年9月在我院骨科门诊接受手术治疗的78例94个椎体患者临床资料，随机双盲法分为研究组40例和对照组38例,研究组行经皮椎体后凸成形术(PKP)治疗，对照组接受经皮椎体成形术(PVP)手术，随访比较2组手术前后疼痛视觉模拟评分(VAS)、后凸Cobb角及骨水泥渗漏发生情况。结果：2组术前VAS评分差异无统计学意义(P>0.05),术后1周随访VAS评分均较术前显著降低(P<0.05),但2组术后Id随访VAS评分无显著性差异(P>0.05)o2组术后随访后凸Cobb角和椎体高度均较术前明显改善(PV0.05),且PKP组改善幅度明显大于PVP组(PV0.05)。结论：PKP和PVP均对治疗骨质疏松性椎体压缩骨折有良好的止痛效果，但行PKP手术的患者术后压缩椎体后凸角、中部高度恢复程度更显著，骨水泥渗漏率更低，整体效果优于PVP术，建议临床酌情考虑PKP术式治疗骨质疏松致骨折患者。【关键词】椎体后凸成形术(PKP)；骨质疏松；压缩性骨折；后凸角；疗效【中图分类号】R681【文献标识码】A【文章编号】1004-6194(2015)01-0054-02PKPholdstheideastoexploreinthetreatmentofsenileosteoporosisvertebralfractures[Abstract】Objective：toexploretheprotrudingafterpercutaneousvertebralplasty(PKPholds)inthetreatmentofsenileosteoporosisvertebralfractureclinicalcurativeeffectandsecurity,inordertoimprovetheoldpatientswithosteoporosisfracturetotheoveralloperationcurativeeffect.Methods：aretrospectiveanalysisbetweenSeptember2012andSeptember2012inourhospitalorthopaedicoutpatientsurgerytreatmentof78casesofclinicaldataof94patientswithvertebralbody,randomized,double-blindmethodisdividedintoresearchgroup40casesandcontrolgroup38cases,theteamthroughtheskinoftheprotrudingaftervertebralplasty(PKPholds)treatment,thecontrolgroupreceivedpercutaneousvertebralplasty(PVP)surgery,follow-uptocomparetwogroupsbeforeandaftersurgerypainafterthevisualanaloguescale(VAS),convexCobbAngleandbonecementleakagehappening.Results：preoperativeVASscorediffereneeoftwogroupshavenostatisticalsignificance(P>0.05),postoperative1weekfollow-upVASscoreswerecomparedwithpreoperativesignificantlyreduced(P<0.05),butthetwogroupsofpostoperativefollow-upof1dVASscoretherewasnosignificantdifferenee(P>0.05).Twogroupsofpostoperativefollow-upoftheprotrudingafterCobbAngleandheightofvertebralbodywerecomparedwithpreoperativeimprovedsignificantly(P<0.05),andPKPholdshasimprovedsignificantlygreaterthanPVPgroup(P<0.05).Conclusion：PVPandPKPholdsforthetreatmentofosteoporoticvertebralcompressionfractureshasgoodanalgesiceffect,butthelineoftheprotrudingafterPKPholdsthesurgeryofpatientswithpostoperativecompressionvertebralbodymoreprominentcentralAngle,highrecoverydegree,thebonecementleakagerateislower,theoveralleffectisbetterthanthatofPVP,suggestsdiscretionaryconsiderPKPholdsinclinicalsurgeryinthetreatmentofosteoporosisfracturepatientSo【Keyword]Convexkeratoplastyaftervertebralbodies(PKPholds);Osteoporosis;Compressionfractures;AftertheconvexAngle;Thecurativeeffect骨质疏松性椎体骨折是老年人群最为常见的骨质疏松症并发症，我们常提到的骨质疏松性椎体骨折，其实质指的是骨质疏松性椎体压缩骨折。BuchblindR等认为，骨质疏松性椎体压缩骨折系骨质进行性脱钙和骨小梁结构异常，患者脊柱在轻微外力下发生的压缩性骨折，由于脊柱连接腰背的生理构造，因此患者多表现为腰背疼痛、脊柱后凸等，严重影...