摘要
目的对比经皮椎体成形术(percutaneous vertebroplasty,PVP)与椎体后凸成形术(percutaneous kyphoplasty,PKP)两种手术方式治疗累及椎体中1/3的急性骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效。方法回顾性纳入西安市红会医院2017年1月至2018年12月收治的单节段骨折累及椎体中1/3的急性OVCF病人117例,根据手术方法进行分组,PVP组61例,PKP组56例。对两组病人性别、年龄、身高、体重、术前骨密度、骨水泥注入量、疼痛视觉模拟量表(visual analogue score,VAS)评分、ODI功能障碍指数(Oswestry disability index,ODI)、SF-36生活质量评分(The MOS item short from health survey,SF-36)、椎体前缘高度、局部伤椎Cobb角、骨水泥渗漏发生率及术后邻近椎体新发骨折发生率等资料进行统计分析。结果两组术后1 d及末次随访时的ODI、VAS、SF-36评分均显著优于术前,末次随访时的评分显著优于术后1 d的评分(P<0.05);但同时段两组间比较,差异无统计学意义(P>0.05)。两组术后1 d及末次随访时椎体前缘高度、伤椎Cobb角均优于术前(P<0.05),PKP组术后1 d及末次随访时的椎体前缘高度高于PVP组、伤椎Cobb角小于PVP组(P<0.05)。PKP组骨水泥渗漏率与邻近椎体新发骨折发生率均明显低于PVP组,差异有统计学意义(P<0.05)。结论对于骨折累及椎体中1/3的急性OVCF病人,PKP与PVP均有良好的镇痛效果,但PKP在椎体前缘高度与伤椎Cobb角的恢复上表现更为优异,且骨水泥渗漏与邻近椎体新发骨折发生率均较低,推荐骨折累及椎体中1/3的急性OVCF病人使用PKP手术进行治疗。
Objective To compare the clinical efficacy of percutaneous vertebroplasty(PVP)and kyphoplasty(PKP)in the treatment of acute osteoporotic vertebral compression fracture(OVCF)involving 1/3 of the vertebral body.Methods A total of 117 acute OVCF patients with single segment fracture involving 1/3 of the vertebral body treated in Xi’an Honghui Hospital from January 2017 to December 2018 were retrospectively included.The patients were divided into 61 cases in PVP group and 56 cases in PKP group according to the surgical methods.The gender,age,height,weight,preoperative bone mineral density,bone cement injection volume,the visual analog score(VAS),Oswestry disability index(ODI),the MOS item short from health survey(SF-36),anterior height of vertebral body,fracture vertebra Cobb angle,the incidence of bone cement leakage and adjacent vertebral fracture were statistically analyzed.Results The scores of ODI,VAS and SF-36 at 1st day after operation and the last follow-up were significantly better than those before operation,and the score at the last follow-up was significantly better than that at 1st day after operation(P<0.05),but there was no significant difference between the two groups at the same time point(P>0.05).The anterior height of vertebral body and fracture vertebra Cobb angle in the two groups at 1st day after operation and the last follow-up were better than those before operation(P<0.05),and the anterior height of vertebral body in PKP group at 1 day after operation and the last follow-up was higher than that in PVP group,while the fracture vertebra Cobb angle in PKP group was significantly smaller than that in PVP group(P<0.05).The incidence of bone cement leakage and adjacent vertebral fracture in PKP group was significantly lower than that in PVP group(P<0.05).Conclusion Both PKP and PVP have good analgesic effects in acute OVCF patients with fracture involvement in 1/3 of the vertebral body.PKP has better performance in the recovery of AVH and FVCA,and the incidence of BCL and AVF is low.Therefore,PKP surgery is recommended for acute OVCF patients with fracture involvement in 1/3 of the vertebral body.
作者
张子龙
杨俊松
井齐明
郝定均
ZHANG Zi-long;YANG Jun-song;JING Qi-ming;HAO Ding-jun(Department of Orthopaedics,Honghui Hospital Affiliated to Medical College of Xi'an Jiaotong University,Xi'an 710054,China;Xi'an Medical College,Xi'an 710045,China)
出处
《骨科》
CAS
2022年第1期34-40,共7页
ORTHOPAEDICS
基金
国家自然科学基金(81830077)。
关键词
骨质疏松
椎体成形术
椎体后凸成形术
骨折线
椎体中1/3
Osteoporosis
Percutaneous vertebroplasty
Percutaneous kyphoplasty
Fracture line
1/3 of the vertebral body
