摘要
目的比较Jack椎体扩张器后凸成形术(DKP)与Kyphon球囊扩张后凸成形术(BKP)治疗骨质疏松椎体压缩性骨折(OVCF)术后伤椎高度丢失与邻近椎间盘退变的情况。方法回顾性研究2007年5月至2016年10月南京医科大学第一附属医院骨科收治的94例OVCF患者资料。根据治疗方法不同分为两组:DKP组(采用DKP治疗)30例,男18例,女12例;年龄(72.4±9.2)岁,骨密度值(-3.99±0.88)SD,病程(0.7±0.4)个月。BKP组(采用DKP治疗)64例,男28例,女36例;年龄(71.6±14.3)岁,骨密度值(-4.08±0.63)SD,病程(0.6±0.3)个月。比较两组患者术前、术后2 d及术后36个月伤椎高度变化、邻近椎间盘高度指数百分比(DHIP)和椎间盘退变的Pfirrmann分级。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。两组患者术后36个月伤椎前缘、中间高度及DHIP均低于术后2 d,差异有统计学意义(P<0.05)。DKP组、BKP组术后36个月椎间盘高度指数百分比(79.86%±4.48%、80.24%±6.85%)比较差异无统计学意义(t=0.277,P=0.782)。DKP组、BKP组分别有36、84例患者Pfirmman分级发生退变,两组椎间盘退变发生率(60.0%vs.65.6%)比较差异无统计学意义(χ^(2)=0.560,P=0.454)。结论DKP和BKP治疗OVCF远期均可能出现伤椎高度丢失和相邻椎间盘退变,但两组椎间盘退变无明显差异。
Objective To compare Jack dilator-kyphoplasty(DKP)and balloon-kyphoplasty(BKP)for osteoporotic vertebral compression fracture(OVCF)in postoperative vertebral height loss and adjacent intervertebral disc degeneration.Methods A total of 94 OVCF patients were treated and fully followed up at Department of Orthopaedic Surgery,The First Hospital Affiliated to Nanjing Medical University from May 2007 to October 2016.Of them,30 were subjected to DKP and 64 to BKP.In DKP group,there were 18 males and 12 females,with an age of(72.4±9.2)years,a bone density of(-3.99±0.88)SD and a disease course of(0.7±0.4)months;in BKP group,there were 28 males and 36 females,with an age of(71.6±14.3)years,a bone density of(-4.08±0.63)SD and a disease course of(0.6±0.3)months.The 2 groups were compared in terms of change in the height of injured vertebrae,disc height index percentage(DHIP)and Pfirrmann grading of adjacent disc degeneration at preoperation,2 days and 36 months after operation.Results The 2 groups were comparable due to insignificant differences in their preoperative general data(P>0.05).The anterior and middle heights of injured vertebrae and DHIP at postoperative 36 months were significantly lower than those at postoperative 2 days in both groups(P<0.05).There was no significant difference between the 2 groups in DHIP at 36 months after operation(79.86%±4.48%versus 80.24%±6.85%)(t=0.277,P=0.782).By the Pfirrmann grading,36 and 84 patients had intervertebral disc degeneration in DKP and BKP groups respectively.There was no significant difference in the incidence of intervertebral disc degeneration between the 2 groups(60.0%versus 65.6%)(χ^(2)=0.560,P=0.454).Conclusions In the OVCF treatment,DKP and BKP may potentially cause height loss of the injured vertebrae and degeneration of adjacent intervertebral disc,but no difference was found in disc degeneration between the 2 modes.
作者
吴旋
陈建
余利鹏
殷国勇
Wu Xuan;Chen Jian;Yu Lipeng;Yin Guoyong(Department of Orthopaedic Surgery,The First Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China;Department of Orthopaedic Surgery,Zhongda Hospital,Dongnan University,Nanjing 210009,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2022年第1期61-67,共7页
Chinese Journal of Orthopaedic Trauma
