摘要
目的比较单侧与双侧经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的疗效。方法回顾性分析2021年1月至2023年1月济南市第四人民医院收治的60例骨质疏松性椎体压缩性骨折患者的临床资料,根据治疗方法不同分为单侧手术组和双侧手术组,各30例。单侧手术组采用单侧经皮椎体后凸成形术,双侧手术组采用双侧经皮椎体后凸成形术。比较两组患者手术前后视觉模拟评分法(VAS)评分以及椎体后凸Cobb角、椎体前缘高度,统计两组患者术后6、12个月椎体再骨折的情况。结果术前,两组患者VAS评分比较差异无统计学意义(P>0.05);术后,两组患者VAS评分均低于术前(P<0.01),但两组间比较差异无统计学意义(P>0.05)。术前,两组患者Cobb角、椎体前缘高度比较差异无统计学意义(P>0.05);术后,双侧手术组Cobb角低于单侧手术组[(10.3±4.0)°比(13.8±5.3)°](P<0.01),椎体前缘高度高于单侧手术组[(20.6±1.3)mm比(19.9±1.3)mm](P<0.05)。术后6、12个月,双侧手术组患者再发骨折率均明显低于单侧手术组[0比30.0%(9/30)、3.3%(1/30)比43.3%(13/30)](P<0.01)。结论单侧与双侧经皮椎体后凸成形术均可明显缓解骨质疏松性椎体压缩性骨折患者疼痛症状,其中双侧经皮椎体后凸成形术在恢复椎体高度、改善Cobb角及避免椎体再骨折方面优于单侧经皮椎体后凸成形术。
Objective To compare the effects of unilateral and bilateral percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures.Methods The clinical data of 60 patients with osteoporotic vertebral compression fracture treated in Jinan Fourth People's Hospital from Jan.2021 to Jan.2023 were retrospectively analyzed.According to treatment methods,they were divided into a unilateral operation group and a bilateral operation group,with 30 cases in each group.Unilateral percutaneous kyphoplasty was performed in the unilateral operation group and bilateral percutaneous kyphoplasty was performed in the bilateral operation group.Visual analogue scale(VAS)scores,kyphotic Cobb angle and anterior vertebral height were compared between the two groups before and after operation,and the vertebral refractures of the two groups 6 and 12 months after operation were analyzed.Results Before surgery,there was no significant difference in VAS scores between the two groups(P>0.05).After surgery,VAS scores in both groups were lower than before surgery(P<0.01),but there was no significant difference between the two groups(P>0.05).Before surgery,there was no significant difference in Cobb angle and anterior vertebral height between the two groups(P>0.05).After surgery,the Cobb angle in the bilateral operation group was lower than that in the unilateral operation group[(10.3±4.0)°vs(13.8±5.3)°](P<0.01),and the anterior vertebral height was higher than that in the unilateral operation group[(20.6±1.3)mm vs(19.9±1.3)mm](P<0.05).At 6 and 12 months after surgery,the recurrent fracture rate in the bilateral operation group was significantly lower than that in the unilateral operation group[0 vs 30.0%(9/30),3.3%(1/30)vs 43.3%(13/30)](P<0.01).Conclusion Both unilateral and bilateral percutaneous kyphoplasty can significantly alleviate the pain symptoms of the patients.Bilateral percutaneous kyphoplasty is better than unilateral percutaneous kyphoplasty in restoring vertebral body height,improving Cobb angle and avoiding refracture of the vertebral body.
作者
常刚
邱思强
左金良
韩建龙
CHANG Gang;QIU Siqiang;ZUO Jinliang;HAN Jianlong(Department of Spine Surgery,Jinan Fourth People's Hospital,Jinan 250031,China)
出处
《医学综述》
2025年第5期630-635,共6页
Medical Recapitulate
基金
济南市卫生健康委员会科技计划项目(2022-1-24)。
关键词
椎体压缩性骨折
再骨折
骨质疏松
后凸成形术
Vertebral compression fracture
Refracture
Osteoporosis
Percutaneous kyphoplasty
