张子龙,杨俊松,郝定均.经皮椎体成形术与经皮椎体后凸成形术治疗相邻双椎体急性骨质疏松性椎体压缩骨折的临床对比研究.骨科,2021,12(1): 1-7. |
经皮椎体成形术与经皮椎体后凸成形术治疗相邻双椎体急性骨质疏松性椎体压缩骨折的临床对比研究 |
Clinical comparison of PKP vs. PVP in acute osteoporotic vertebral compression fracture of adjacent vertebral bodies |
投稿时间:2020-07-09 |
DOI:10.3969/j.issn.1674-8573.2021.01.001 |
中文关键词: 相邻双椎体 骨质疏松性骨折 经皮椎体成形术 经皮椎体后凸成形术 骨水泥渗漏 |
英文关键词: Adjacent double vertebral bodies Osteoporotic fracture Percutaneous vertebroplasty Percutaneous kyphoplasty Bone cement leakage |
基金项目:国家自然科学基金(81772357) |
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中文摘要: |
目的 比较经皮椎体成形术(percutaneous vertebroplasty,PVP)与经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗相邻双椎体急性骨质疏松性椎体压缩骨折(osteoporotic vetebral compression fractures,OVCF)的临床疗效。方法 回顾性分析西安交通大学医学院附属红会医院2015年1月至2017年12月收治的134例相邻双椎体急性OVCF病人的临床资料,根据手术方式分为PKP组(61例)与PVP组(73例)。比较两组术前、术后及末次随访时的疼痛视觉模拟量表评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)、椎体前缘高度、伤椎局部Cobb角、骨水泥渗漏情况及邻近椎体新发骨折情况。结果 两组病人术后及末次随访时的VAS评分和ODI均显著优于术前,差异均有统计学意义(P均<0.05),但两组间术前、术后及末次随访时的VAS评分、ODI比较,差异均无统计学意义(P均>0.05)。术后及末次随访时,PKP组的椎体前缘高度和伤椎局部Cobb角均显著优于PVP组,组间比较,差异均有统计学意义(P均<0.05)。PKP组和PVP组的骨水泥渗漏率分别为14.75%、32.88%,邻近椎体新发骨折率分别为11.48%、27.40%,两组比较,差异均有统计学意义(P均<0.05)。结论 与PVP手术治疗比较,PKP手术治疗相邻双椎体急性OVCF可有效恢复椎体高度,降低骨水泥渗漏率及邻近椎体新发骨折的风险,病人预后更好。 |
英文摘要: |
Objective To compare the efficacy of percutaneous vertebroplasty (PVP) vs. percutaneous kyphoplasty (PKP) in the treatment of acute osteoporoscopic fractures of adjacent bilateral vertebral bodies. Methods The data of 134 patients with acute osteoporotic fractures of adjacent bilateral vertebral bodies in our hospital from January 2015 to December 2017 were retrospectively included and analyzed. According to different surgical methods, the patients were divided into PKP group (61 cases) and PVP group (73 cases). The visual analogue scale (VAS) score, Oswestry Disability Index (ODI), anterior vertebral edge height, local Cobb angle of the injured vertebra, bone cement leakage, and new vertebral fractures in the adjacent vertebra were analyzed. Results The VAS score and ODI in the two groups after operation and at the last follow-up were significantly better than those before operation (all P<0.05), but there was no significant difference in VAS score and ODI between the two groups (all P>0.05). After surgery and at the last follow-up, the height of anterior vertebral edge and local Cobb angle of the injured vertebrae in PKP group were better than those in PVP group (all P<0.05). The bone cement leakage rate of bone cement in PKP group and PVP group was 14.75% and 32.88%, and the new fracture rate of adjacent vertebral body was 11.48% and 27.40%, respectively, with the differences being statistically significant (both P<0.05). Conclusion For patients with acute osteoporotic fractures of adjacent vertebral bodies, compared with PVP, PKP can effectively restore vertebral height, reduce bone cement leakage rate and the risk of new fractures of adjacent vertebral bodies, and obtain more satisfactory efficacy. |
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