| 梁东星,郭永军,付鲲鹏,等.两种椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的对比研究.骨科,2025,16(3): 193-199. |
| 两种椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的对比研究 |
| A comparative study of two kinds of kyphoplasty in the treatment of elderly patients with osteoporotic vertebral compression fractures |
| 投稿时间：2025-01-15 |
| DOI：10.3969/j.issn.1674-8573.2025.03.001 |
| 中文关键词: 经皮弯角球囊椎体后凸成形术 经皮椎体后凸成形术 老年人 骨质疏松性椎体压缩骨折 术后恢复 |
| 英文关键词: Percutaneous curved kyphoplasty Percutaneous kyphoplasty Elderly Osteoporotic vertebral compression fractures Postoperative recovery |
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| 中文摘要: |
| 目的 对比分析经皮弯角球囊椎体后凸成形术（PCKP）与经皮椎体后凸成形术（PKP）治疗老年骨质疏松性椎体压缩骨折（OVCF）的围术期指标及临床疗效。方法 采用单中心回顾性队列研究，纳入我科2020年6月至2024年5月收治的OVCF病人45例，根据术式分为PCKP组（22例）与PKP组（23例）。记录两组病人基线资料（性别、年龄、骨密度、骨折节段等），比较手术时间、术中透视次数、骨水泥注射量等围术期指标；通过X线片评估骨水泥弥散程度，测量椎体前缘高度（AVH）恢复率、后凸Cobb角，采用疼痛视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）评估疼痛及功能改善情况。结果 与PKP组比较，PCKP组手术时间少[（40.59±4.01） min vs. （50.39±3.05） min]、透视次数少[（12.18±1.76）次 vs. （17.47±3.14）次]、骨水泥注射量大[（5.72±1.31） mL vs. （4.43±1.16） mL]，差异有统计学意义（P＜0.05）。PCKP组的骨水泥弥散率评价为优比例显著高于PKP组（45.45% vs. 17.39%，P＜0.05）。术后3天，与PKP组比较，PCKP组术后Cobb角改善更显著（7.22°±1.54° vs. 10.78°±1.50°，P＜0.001），AVH恢复率更高（14.04%±1.39% vs. 7.95%±1.06%，P＜0.001）；术后6个月时，PCKP组的AVH恢复率、后凸Cobb角、VAS评分和ODI均显著优于PKP组（P＜0.05）。结论 PCKP与PKP均可有效缓解OVCF病人疼痛并改善功能，PCKP在缩短手术时间、降低辐射暴露、优化骨水泥分布及椎体高度恢复方面更具优势，在中长期随访功能恢复和疼痛控制方面效果更佳，具有临床推广价值。 |
| 英文摘要: |
| Objective To compare the perioperative indicators and clinical efficacy of percutaneous curved kyphoplasty (PCKP) versus percutaneous kyphoplasty (PKP) in the treatment of elderly patients with osteoporotic vertebral compression fractures (OVCF). Methods A single-center retrospective cohort study was conducted, including 45 OVCF patients admitted between June 2020 and May 2024, which were divided into PCKP (22 cases) and PKP (23 cases) groups based on surgical approach. Baseline data (gender, age, bone mineral density, fracture level) were recorded. Perioperative indicators, including operative time, intraoperative fluoroscopy frequency, and bone cement injection volume, were compared. Bone cement dispersion was evaluated via X-ray, vertebral anterior height (AVH) recovery rate and Cobb angle were measured, and clinical outcomes were assessed using the visual analogue scale (VAS) and Oswestry disability index (ODI). Results The PCKP group had a shorter surgical time [(40.59±4.01) min vs. (50.39±3.05) min], fewer fluoroscopy frequency (12.18±1.76 vs. 17.47±3.14), and larger bone cement volume [(5.72±1.31) mL vs. (4.43±1.16) mL] than the PKP group, with statistically significant differences (P＜0.05). The bone cement dispersion rate in the PCKP group was significantly better than that in the PKP group, with 45.45% rated as “excellent” in PCKP versus 17.39% in PKP (P＜0.05). At 3rd day postoperatively, the postoperative Cobb angle improvement was more significant in the PCKP group (7.22°±1.54° vs. 10.78°±1.50°, P＜0.001), and the AVH recovery rate was higher (14.04%±1.39% vs. 7.95%±1.06%, P＜0.001) than the PKP group. At 6th month postoperatively, the recovery rate of AVH, kyphotic Cobb angle, VAS score, and ODI in the PCKP group were significantly better than those in the PKP group (P＜0.05). Conclusion Both PCKP and PKP effectively alleviate pain and improve function in OVCF patients. PCKP offers advantages in shortening operative time, reducing radiation exposure, optimizing bone cement distribution, and restoring vertebral height. Medium to long-term follow-up highlights the superior efficacy of PCKP in functional recovery and pain management demonstrating significant clinical value for widespread application. |
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