摘要
[目的]前瞻性比较经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)治疗单节段骨质疏松性椎体压缩骨折(OVCF)伴椎管狭窄但无神经症状的临床疗效。[方法]2014年7月～2016年6月87例单节段骨质疏松性椎体压缩骨折伴椎管狭窄但无神经症状的患者纳入本研究,按随机数字法分为PVP组43例和PKP组44例,分别行PVP和PKP治疗。比较分析两组手术时间、骨水泥注入量、X线曝光次数、术后住院时间、并发症和VAS和ODI评分。影像测量并比较椎体平均高度、后突骨块长度、后凸角。[结果]PKP组手术时间和骨水泥注入量显著大于PVP组(P<0.05),但两组X线曝光次数和住院时间差异无统计学意义(P>0.05),两组术后相关并发症发生率差异也无明显统计学意义(P>0.05)。所有患者均获得24～36个月的随访,两组末次随访的VAS及ODI评分较术前均明显减少(P<0.05),但相应时间点两组间VAS和ODI评分差异无统计学意义(P>0.05)。影像测量方面,PKP组的椎体高度恢复及后凸角矫正显著优于PVP组(P<0.05),此外PKP组后突骨块矫正也明显优于PVP组(P<0.05)。[结论]PVP与PKP治疗伴椎管狭窄但无神经症状的单节段骨质疏松性椎体压缩骨折的临床疗效基本相近,均能取得良好临床效果,但PKP椎体高度恢复、术后后凸矫正优于PVP。
[Objective] To prospectively compare the clinical outcomes of percutaneous vertebroplasty (PVP) versus percutaneous kyphoplasty (PKP) for single segment osteoporotic vertebral compression fractures (OVCF) accompanied with spinal stenosis without neurological symptoms.[Methods] From July 2014 to June 2016, 87 patients with single-segment osteoporotic vertebral compression fractures accompanied with spinal stenosis without neurological symptoms were included into this study and divided into two groups by random number. Of them, 43 patients received PVP, while the remaining 44 patients underwent PKP. The operation time, bone cement injection volume, X-ray exposure times, hospital stay, complications, visual analogue scale (VAS) for pain and Oswestry disability index (ODI) were compared between the two groups. In addition, the height of verte-bral body on average, length of posteriorly protrusive bone fragment and kyphotic angle of the involved vertebrae were measured radiographically and compared.[Results] The PKP group consumed significantly longer operation time, and received significantly greater volume of bone cement injected than the PVP group (P<0.05), although no statistically significant differences were noticed regarding to the X-ray exposure times, hospital stay, and postoperative complications between the two groups (P>0.05). All patients were followed up for 24 to 36 months. At the latest follow up, the VAS and ODI scores significantly reduced compared those before operation (P<0.05), despite of the fact that no a statistically significant difference was proved between them at any corresponding time point (P>0.05). In term of radiographic measurements, the PKP group proved significantly superior to the PVP group regarding to restoration of the vertebral body height, decrease of the posteriorly protrusive fragment length, and correction of kyphosis of the involved vertebrae (P<0.05).[Conclusion] Both PVP and PKP are effective treatment for singlelevel osteoporotic vertebral compression accompanied with sp
作者
黄砖枝
陈志达
薛超
郭志民
刘晖
林斌
HUANG Zhuan-zhi;CHEN Zhi-da;XUE Chao;GUO Zhi-min;LIU Hui;LIN Bin(Department of Orthopaedics, the 909h Hospital of PLA, Affiliated Southeast Hospital of Xiamen University, Orthopaedic Center of People's Liberation Army, Zhangzhou, Fujian 363000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第10期890-894,共5页
Orthopedic Journal of China
基金
原南京军区医学科技创新重点课题(编号:12Z24)
关键词
骨质疏松
椎体压缩骨折
经皮椎体成形术
经皮椎体后凸成形术
椎管狭窄
osteoporosis
vertebral compression fractures
percutaneous vertebroplasty
percutaneous kyphoplasty
spinal canal stenosis
