摘要
目的比较经皮椎体成形术(PVP)与经皮球囊扩张椎体成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCFs)的临床效果及安全性。方法回顾性收集胸腰段单一椎体压缩骨折患者103例,PVP组48例,PKP组55例。比较2组手术时间、X线透视次数、骨水泥注入量及骨水泥渗透率的不同。随访并比较2组手术前后的视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数(ODI)、椎体前缘高度及椎体后凸畸形Cobb角的变化。结果103例患者均获得完整随访,PVP组的手术时间、X线透视次数、骨水泥注入量明显低于PKP组(P<0.05);PVP组骨水泥泄露率明显高于PKP组(P<0.05)。2组术后2 d,6个月,12个月VAS、ODI评分较术前均显著改善(P<0.05),但组间比较差异无统计学意义(P>0.05)。术后随访各时间点椎体前缘高度PVP组明显低于PKP组(P<0.05),术后1年伤椎后凸畸形Cobb角平均纠正角度PVP组明显低于PKP组(P<0.01)。结论 PVP及PKP在治疗OVCFs中均取得满意临床疗效,均可明显缓解骨折引起的疼痛,PKP在恢复椎体高度及纠正后凸畸形方面具有优势,但PVP费用相对较低,且术中操作简单,值得进一步研究并推广。
Objective To compare the clinical efficacy and safety of percutaneous vertebroplasty(PVP)and percutaneous vertebroplasty(PKP)with balloon dilatation in the treatment of osteoporotic vertebral compression frac-tures(OVCFs).Methods A total of 103 patients with single thoracolumbar OVCFs were retrospectively included in the study and divided into the PVP group(n=48)andPKP group(n=55).The differences in the mean operative time,X-ray exposure frequency,and injection volume and permeability of bone cement were compared between the two groups.The changes in the scores of visual analog scale(VAS)and Oswestry disability index(ODI),posterior vertebral body height and vertebral kyphotic angle by using the Cobb angle were followed up and compared at the baseline and after the operation between the two groups.Results All patients were followed up.The mean operative time,X-ray exposure frequency,and injection volume of bone cement in the PVP group were significantly lower than those in the PKP group(P<0.05).The leakage rate of bone cement in the PVP group was significantly higher than that in the PKP group(P<0.05).At 2d and 6 months after the operation,the VAS and ODI scores in the two groups were significantly improved compared with those before the operation(P<0.05),whereas there were no statistically significant differences between the two groups(P >0.05).The posterior vertebral body height at different time points after postoperative follow-up in the PVP group was significantly lower than that in the PKP group(P<0.05).The average vertebral kyphotic angle corrected by using the Cobb angle at 1 year after the operation in the PVP group was significanty lower than that in the PKP group(P<0.01).Conclusion PVP and PKP have achieved satisfactory clinical outcomes in the treatment of OVCFs,and can alleviate the pain caused by fractures.PKP favors the recovery of vertebral body height and the correction of vertebral kyphosis.However,the cost of PVP is relatively low,and its intraoperative operation is simple,which justifies furthe
作者
郝海虎
刘强
吴斗
屈建华
孟庆鑫
邢浩
Hao Haihu;Liu Qiang;Wu Dou;Qu Jianhua;Meng Qingxin;Xing Hao(Department of Orthopaedics,Shanxi Dayi Hospital,Shanxi Academy of Medical Sciences,Taiyuan 030032,China)
出处
《中国药物与临床》
CAS
2019年第3期352-354,共3页
Chinese Remedies & Clinics
基金
山西省科技基础条件平台项目(2015091002-0105)
