单双侧穿刺PKP治疗骨质疏松椎体压缩性骨折的对比分析  

Comparison of unilateral and bilateral penetrating kyphoplasty for osteoporotic centrum compression fractures

作　　者：李龙[1,2] 王蒙[1,2] 马华松[1,2] 周雪峰[1,2] 周建伟[1,2] 陈阳[1,2] 马晓明[1,2] 

机构地区：[1]安徽医科大学解放军第306医院临床学院,北京100101 [2]解放军第306医院骨科全军脊柱外科中心,北京100101

出　　处：《中国矫形外科杂志》2014年第8期678-682,共5页Orthopedic Journal of China

摘　　要：[目的]对比分析单侧与双侧经皮穿刺球囊扩张椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松椎体压缩性骨折(OVCFs)的临床疗效。[方法]采用随机对照研究,对本院OVCFs患者行PKP手术治疗75例,根据入院顺序,单数行单侧PKP(38例),偶数行双侧PKP(37例),同时抗骨质疏松治疗,术后随访2年;记录相关指标并进行比较分析。[结果]所有患者手术均顺利完成并得到随访,比较两组患者年龄,住院时间,骨折时间,骨密度无显著性差异(P>0.05)。组内比较术前、术后腰背部疼痛VAS评分,责任椎体前缘、中间高度,局部Cobb角,差异均具有统计学意义(P<0.05),术后组间比较无统计学意义(P>0.05)。手术时间,透视次数,骨水泥注入量,组间比较具有统计学意义(P<0.05)。双侧组骨水泥渗透率和临近椎体再骨折率高于单侧组。骨水泥渗透(8例),合并临近椎体再骨折6例。[结论](1)单侧PKP在治疗新鲜OVCFs疗效方面可以取得与双侧同样满意的疗效;(2)单侧PKP具有手术时间短,透视次数少,骨水泥注射量少,骨水泥渗透率、临近椎体再骨折率低等优点;(3)骨水泥渗漏与临近椎体再骨折具有相关性。[ Objective ] To compare the clinical efficacy of unipedicular percutaneous kyphoplasty （PKP） with the bipedic- ular one in the treatment of osteoporotic vertebral compression fractures （OVCFs）. [ Method ] A a randomized control trial was performed,75 patients with OVCFs were enrolled. Patients were assigned a specific number on admission （1,2,3, etc. ）, those with an odd number received unipedicular PKP （38 cases）, whereas others with an even number receieved unipedicular PKP （37 cases）. After the surgery,all the patients were treated with anti -osteoporosis medication and followed up for 24 months. [ Result] No significant differences were noted between the two groups in terms of age, duration of hospital stay, fracture healing time, and bone mineral density （P 〉 O. 05）. Postoperation, the visual analogue scale score, anterior/medium height of the verte- brae body, and Cobb angle were significantly improved （ P 〈 0.05 ）. The operative time, average number of fluoroscopy proce- dures, bone cement injection volume ,bone cement leakage rate, and adjacent secondary vertebral fracture rate in the unilateral group were significantly lower than those in the bilateral group （ P 〈 0.05 ）. [ Conclusion ] Both unilateral and bilateral ky- phoplasty are reliable for the treatment of OVCFs. Compared with bilateral PKP, unilateral PKP mhas a lower operative time, av- erage number of fluoroscopy procedures,bone cement injection volume, bone cement leakage rate, and adjacent secondary verte- bral fracture rate. Bone cement leakage may be correlated with the occurrence of adjacent secondary vertebral fracture after PKP in the treatment of OVCFs.

关 键 词：单侧穿刺 双侧穿刺 骨质疏松 椎体压缩性骨折 经皮椎体后凸成形术 

分 类 号：R687.3[医药卫生—骨科学]