经皮椎体成形和椎体后凸成形治疗骨质疏松性胸腰椎骨折疗效的回顾性队列研究  

Percutaneous Vertebroplasty versus Percutaneous Kyphoplasty for Osteoporotic Vertebral Compressive Fracture: A Retrospective Cohort Study

作　　者：杨保华[1,2] 李国胜[2] 张义峰[2] 周勇[1] 冯世庆[1] 

机构地区：[1]天津医科大学总医院骨科,天津300052 [2]海洋石油总医院骨科,天津300452

出　　处：《中国循证医学杂志》2015年第4期377-380,共4页Chinese Journal of Evidence-based Medicine

摘　　要：目的比较经皮椎体成形术（percutaneous vertebroplasty,PVP）与经皮椎体后凸成形术（percutaneous kyphoplasty,PKP）治疗骨质疏松性椎体压缩性骨折（osteoporotic vertebral compressive fracture,OVCF）的临床疗效。方法采用回顾性队列研究设计,纳入天津医科大学总医院骨科2008年2月-2013年2月因OVCF行PVP和PKP手术的患者,比较两种手术治疗前后1天的疼痛程度视觉模拟量表（VAS）评分、椎体后凸角、椎体高度和骨水泥渗漏情况。统计分析采用SPSS 13.0软件。结果共纳入55例患者,其中PVP组25例,PKP组30例。随访时间5-20个月,平均15.5个月。两组术后VAS评分均较术前明显改善（P均〈0.05）,但组间术后VAS评分差异无统计学意义;两组术后椎体后凸角变化和椎体高度变化也均较术前明显改善（P均〈0.05）,PKP组恢复椎体高度的效果更好（P〈0.05）;PVP组发生6例骨水泥渗漏,而PKP组仅发生4例,但两组差异无统计学意义（P=0.503）。PVP组再发椎体骨折5例（16%）,PKP组7例（23.3%）。结论采用PVP及PKP治疗OVCF能迅速缓解疼痛,增加椎体的稳定性。PKP恢复椎体高度的效果更好,且有降低骨水泥渗漏发生率的趋势。Objective Evaluating the clinical efficacy of percutaneous vertebroplasty（PVP） and percutaneous kyphoplasty（PKP） for osteoporotic vertebral compressive fracture（OVCF）. Methods Patients with OVCF were retrospectively analyzed from Feb. 2008 to Feb. 2013 in Department of Orthopaedics, Tianjin Medical University General Hospital. Patients were divided into the PVP group and the PKP group. The VAS, vertebral kyphosis angle, vertebral height and bone cement leakage of both groups were compared, and the SPSS13.0 software was used for data analysis. Results A total of 55 patients were included. Of which, 25 patients were in the PVP group and 30 patients were in the PKP group. All patients were followed up from 5 to 20 months, with an average time of 15.5 months. The VAS scores in both groups were all improved after the operation（P〈0.05）, but no significant difference was found between both groups. The vertebral kyphosis angle in both groups were improved after the operation（P〈0.05）, and the PKP group was better than the PVP group. Six patients in the PVP group occurred the leakage of bone cement, and 4 patients in the PKP group. Five patients in the PVP groups occurred vertebral fracture again, while 7 patients in the PKP group. Conclusion Using PVP and PKP for the treatment of OVCF can quickly relieve pain and increase the stability of the vertebral body. PKP can restore vertebral body height better and reduce the incidence of cement leakage.

关 键 词：骨质疏松 胸腰椎压缩性骨折 经皮椎体成形术 经皮椎体后凸成形术 队列研究 

分 类 号：R687.3[医药卫生—骨科学]