球囊与扩张矫形器辅助的椎体后凸成形术治疗骨质疏松性椎体压缩骨折的比较  

Balloon versus expander assisted kyphoplasty for the treatment of osteoporotic vertebral compression fracture

作　　者：侯伟[1] 熊小明[1] 万趸[1] 邓轩赓[1] 石华刚[1] 宋偲茂[1] 梅国龙[1] 

机构地区：[1]四川省骨科医院脊柱科,四川成都610041

出　　处：《中国矫形外科杂志》2017年第18期1633-1636,共4页Orthopedic Journal of China

摘　　要：[目的]比较球囊辅助椎体后凸成形术(balloon kyphoplasty,BKP)和扩张矫形器辅助椎体后凸成形术(expander kyphoplasty,EKP)在治疗骨质疏松性椎体压缩骨折(osteoporosis vertebral compression fractures,OVCFs)的临床疗效差异。[方法]2014年1月~2015年1月,120例骨质疏松症合并胸腰椎单节椎体压缩性骨折患者进行椎体成形术治疗,根据手术使用器材不同,分为EKP组(60例)和BKP组(60例),分析两组患者临床资料,包括性别、年龄、手术时间,观察骨水泥注入量、测量椎体后凸角度(Cobb角法)及并发症情况,术前、术后1 d,术后1、3、6个月、1年分别采用VAS(视觉模拟评分法)评分系统评估患者疼痛情况,椎体前缘高度压缩率恢复值及后凸角度改善情况比较两组的临床疗效。[结果]两组患者性别、年龄、手术时间、术后随访时间差异无统计学意义(P>0.05)。BKP组骨水泥注入量较EKP组大(5.64±0.57)ml vs.(4.28±0.51)ml(P<0.05)。PKP组椎体前缘高度压缩率改善率较EKP组明显(10.87±2.32)%vs.(9.48±1.43)%(P<0.05)。VAS评分改善、Cobb角改善情况、骨水泥渗漏率两组间差异无统计学意义(P>0.05)。[结论]椎体后凸成形术不同辅助方式手术治疗骨质疏松压缩骨折均能获得良好的临床疗效,EKP在恢复椎体前缘高度的作用上稍逊,但因其价格相对低廉,在椎体高度丢失较小、仅需缓解疼痛及强化椎体的患者可考虑使用。[Objective] To compare the clinical outcomes of Balloon kyphoplasty（PKP） and expander kyphoplasty（EKP） in the treatment of osteoporotic vertebral compression fracture（OVCFs）. [Methods] From January 2014 to January2015, 120 patients with single thoracic or single lumbar osteoporotic vertebral compression fracture received surgical treatment and were divided into PKP group（n=60 cases） and EKP group（n=60 cases）. The gender, age, operation time, injected cement volume, vertebral kyphosis angle（Cobb angle） and the complications were recorded. The VAS scores were assessed preoperatively and at 1 day, 1 month, 3 months, 6 months, 1 year postoperatively. The restoration of vertebral anterior height and the improvement of vertebral kyphosis angle were also determined to compare the clinical outcomes of two groups. [Results]There was no significant difference in gender, age, operation time and follow-up time（P〉0.05）. The BKP group had larger cement injected volume than EKP group [（5.64±0.57） ml vs.（4.28±0.51） ml,（P〈0.05）]. The vertebral anterior height were restored more obviously in PKP group than in EKP group [（10.87±2.32） % vs.（9.48±1.43） %,（P〈0.05）]. However, the improvement of VAS scores and vertebral kyphosis angle, the cement leakage rate had no significant difference between these two groups（P〈0.05）. [Conclusion] Both PKP and EKP are effective methods in the treatment of osteoporotic vertebral compression fracture. EKP is slightly poorer in capability of vertebral height restoration than PKP. Because of its relatively low prices, the patients with only small loss of vertebral height can be considered EKP, when they only need pain relief or vertebrae strengthen.

关 键 词：椎体后凸成形术 骨质疏松压缩骨折 球囊辅助 扩张矫形器辅助 

分 类 号：R687.3[医药卫生—骨科学]