| 谢川江,唐宏,刘港,等.单侧经皮弯角椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的临床研究.骨科,2025,16(6): 481-487. |
| 单侧经皮弯角椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的临床研究 |
| Unilateral percutaneous curved kyphoplasty in the treatment of osteoporotic vertebral compression fractures in the elderly: a clinical study |
| 投稿时间：2025-05-10 |
| DOI：10.3969/j.issn.1674-8573.2025.06.001 |
| 中文关键词: 骨质疏松症 骨质疏松性椎体压缩骨折 经皮穿刺椎体后凸成形术 单侧经皮穿刺弯角椎体后凸成形术 |
| 英文关键词: Osteoporosis Osteoporotic vertebral compression fracture Percutaneous kyphoplasty Unilateral percutaneous curved kyphoplasty |
| 基金项目:重庆市南岸区科卫联合医学科研项目（2023-24） |
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| 中文摘要: |
| 目的 探讨单侧经皮弯角椎体后凸成形术（PCK）治疗老年骨质疏松性椎体压缩骨折（OVCF）的临床疗效。方法 选取2024年1月至2024年12月我院收治的80例OVCF病人作为研究对象，按随机数字表法分为两组。拟行PCK治疗的40例纳入PCK组，拟行双侧经皮椎体后凸成形术（PKP）治疗的40例纳入PKP组。收集记录两组手术前后的腰背部疼痛视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）、伤椎前柱撑开高度及丢失高度、伤椎后凸Cobb角改善度数及丢失度数；对比两组手术时间、术中出血量、骨水泥注入量、骨水泥弥散分布情况、骨水泥渗漏发生率和术中X线透视次数，末次随访时椎体再骨折发生率以及有无其他手术并发症。结果 PCK组手术时间短于PKP组[（37.38±6.59） min vs. （43.88±7.70） min]，术中出血量少于PKP组[（8.75±2.94） mL vs. （12.63±2.53） mL]，骨水泥注入量少于PKP组[（4.61±0.60） mL vs. （5.20±0.71） mL]，术中透视次数少于PKP组[（15.38±2.12）次 vs. （21.58±2.58）次]，骨水泥渗漏发生率显著低于PKP组（5.0% vs. 22.5%），差异均有统计学意义（P＜0.05）。然而两组间骨水泥弥散分布、术后腰背部VAS评分、ODI、伤椎Cobb角改善度数和丢失度数、椎体前柱撑开高度和丢失高度及并发症比较，差异均无统计学意义（P＞0.05）。结论 PCK与双侧PKP治疗老年OVCF早期临床疗效一致，骨水泥分布均满意。PCK具有手术时间短、术中出血量少、骨水泥注入量少、术中X线透视次数少、骨水泥渗漏率低的优势。 |
| 英文摘要: |
| Objective To evaluate the clinical efficacy of unilateral percutaneous curved kyphoplasty (PCK) for treating osteoporotic vertebral compression fractures (OVCF) in elderly patients. Methods A cohort of 80 elderly patients with OVCF was recruited from our hospital during January 2024 to December 2024. According to the random number table method, they were divided into two groups. Forty cases planned for PCK were included in the PCK group, whereas 40 cases planned for bilateral percutaneous kyphoplasty (PKP) treatment were included in the PKP group. The visual analogue scale (VAS) scores for low back pain, Oswestry Disability Index (ODI), the recovery and loss of the anterior height of the injured vertebrae, the improvement and loss of the kyphosis Cobb angle of the vertebrae in the two groups were collected and recorded preoperatively and postoperatively. The operation time, intraoperative blood loss, bone cement injection volume, bone cement dispersion distribution, incidence of bone cement leakage, the number of intraoperative X-ray fluoroscopy, the incidence of vertebral refracture at the last follow-up and other complications were compared between the two groups. Results The PCK group had significantly shorter surgical times [(37.38±6.59) min vs. (43.88±7.70) min], less intraoperative blood loss [(8.75±2.94) mL vs. (12.63±2.53) mL], lower volume of cement injection [(4.61±0.60) mL vs. (5.20±0.71) mL], and fewer X-ray fluoroscopy exposures [(15.38±2.12) times vs. (21.58±2.58) times], less cement leakage occurrence (5.0% vs. 22.5%) than in the PKP group with the differences being statistically significant (P＜0.05). However, no significant difference between groups was observed in the diffuse distribution of bone cement, VAS scores, ODI, Cobb angle improvements or losses, anterior vertebral height recovery or loss, or complications (P＞0.05). Conclusion PCK and bilateral PKP have comparable early clinical efficacy in treating OVCF in elderly patients, with satisfactory cement distribution. However, PCK presents several benefits, such as decreased operative duration, reduced intraoperative blood loss, lower volume of cement injection, minimized X-ray fluoroscopy exposure, and a diminished rate of cement leakage. |
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