单侧与双侧经皮椎体后凸成形术治疗骨质疏松性椎体骨折疗效比较  

Clinical comparison of effect on unipedicular versus bipedicular percutaneous kyphoplasty for osteoporotic vertebral compression fractures

作　　者：朱爱祥[1] 朱裕成[1] 郑红兵[1] 王冰[1] 马军[1] 李涛[1] 

机构地区：[1]南京鼓楼医院集团宿迁市人民医院骨科,江苏宿迁223800

出　　处：《临床骨科杂志》2010年第2期132-134,共3页Journal of Clinical Orthopaedics

摘　　要：目的比较单侧与双侧椎弓根入路经皮椎体后凸成形术治疗骨质疏松性椎体骨折手术疗效。方法56例68节骨质疏松性椎体压缩性骨折患者,单侧经椎弓根入路30例36节椎体,双侧经椎弓根入路26例32节椎体,采用球囊或Sky扩张器行椎体后凸成形术。术前、术后1周、1年进行疼痛视觉类比评分(VAS)、测量椎体高度恢复率、后凸Cobb角。结果患者均获随访,时间1～3年。单侧组及双侧组术后1周及术后1年疼痛视觉类比评分(VAS)、后凸Cobb角较术前均减少(P<0.05)。单侧组术后1周及术后1年后凸Cobb角恢复率分别为50.2%、43.2%;双侧组分别为52.3%、46.9%。单侧组术后1周及术后1年椎高恢复率分别为46.3%、43.6%;双侧组分别为50.2%、46.1%。术后1周及术后1年VAS评分、后凸Cobb角及椎高恢复率单侧组与双侧组比较差异无统计学意义(P>0.05),但VAS评分术后1年较术后1周两组均有所增加。结论采用单侧与双侧经椎弓根入路经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折均能恢复伤椎体高度、纠正后凸Cobb角并缓解疼痛。术后针对骨质疏松症的病因治疗可提高疗效。Objective To compare the clinical effect of unipedicular versus bipedicular percutaneous kyphoplasty（PKP） in the treatment of osteoporotic vertebral compression fractures（OVCFs）.Methods 56 patients（68 segments） with of OVCFs were operated via unipedicular（30 cases,36 segments） or bipedicular（26 cases,32 segments） PKP.VAS score,vertebral restoration rate,and cobb′s angle was evaluated pre-operatively,1 week,and 1 year post-operatively.Results All patients were followed-up for 1~3 years（averaged 2.5 years）.The VAS scores and Cobb′s angle were improved in both unipedicular and bipedicular groups in 1 week and 1 year post-operation.The restoration rate of Cobb′s angle 1 week and 1 year post-operation were 50.2% and 43.2% in unipedicular group,and 52.3% and 46.9% in bipedicular group.The restoration rate of vertebral height 1 week and 1 year post-operation were 46.3% and 43.6% in unipedicular group,and 50.2% and 46.1% in bipedicular group.The VAS scores,Cobb′s angle and the restoration rate of vertebral height were not statistical difference in two groups.Conclusions The vertebral height,Cobb′s angle,and back pain can be improved via both unipedicular and bipedicular PKP in treatment of OVCF.The medicine therapy for osteoporosis is necessary.

关 键 词：脊柱骨折 经皮椎体后凸成形术 骨质疏松 单侧入路 双侧入路 

分 类 号：R687.3[医药卫生—骨科学] R683.2[医药卫生—外科学]