骨质疏松性椎体压缩性骨折行PVP与PKP术后伤椎再塌陷的临床对比分析  

Comparison of the clinical effect of PVP and PKP in the treatment of patients with osteoporotic vertebral compression fracture after operation

作　　者：吴贵根[1] 唐中尧 杨陈一 郑磊[1] 

机构地区：[1]泸州市中医医院脊柱科,四川泸州646000

出　　处：《颈腰痛杂志》2017年第5期412-416,共5页The Journal of Cervicodynia and Lumbodynia

基　　金：2014年泸州市科技计划项目(编号:2014-S-49)

摘　　要：目的探讨PVP与PKP这两种不同的骨水泥填充术式治疗骨质疏松性椎体压缩骨折(Osteoporotic vertebral compression fractures,OVCF),术后伤椎再塌陷的发生情况是否有所差异。方法回顾性分析自2008-03-2014-09采用骨水泥填充技术微创治疗的OVCF患者180例,其中PVP手术122例,PKP手术58例。对两组患者进行术后随访,并对相关指标进行对比。结果随访24-60个月,平均42.3个月,共发生伤椎再塌陷23例,其中PVP术后11例,PKP术后12例;两组发生率对比,PKP组显著高于PVP组,差异有统计学意义(20.69%VS 9.01%,P<0.05)。PVP与PKP两组患者的性别构成、年龄、骨密度值、伤后至手术时间、手术节段等基线资料对比,差异均无统计学意义(P>0.05);两组术后伤椎再塌陷患者的上述基线资料对比,亦无统计学差异(P>0.05)。但两组伤椎高度矫正比,伤椎前缘与中部均无显著性差异(P>0.05);末次随访时的伤椎高度丢失比,PKP组的伤椎前缘与中部丢失比均明显高于PVP组,差异有统计学意义(P<0.05)。结论行骨水泥填充技术治疗OVCF时,以PKP术式的伤椎再塌陷发生率更高。术中应重视骨水泥的弥散效果,以期尽量达到在椎体内均匀分布,以减少其应力集中,避免术后伤椎再塌陷的发生。Objective To compare the effect of PVP and PKP in the treatment of osteoporotic vertebral compression fractures （OVCF）, and whether there were differences in incidence of postoperative ver- tebral collapse situation. Methods A retrospective analysis was conducted in 180 patients with OVCF who were treated by minimally invasive treatment with bone cement filling technique from March 2008 to September, including 122 cases of PVP and 58 cases of PKP operation. Two groups of patients were fol- lowed up, and the related indicators were compared. Results The patients were followed up for 24-60 months, average 42.3 months. A total of 23 cases with vertebral collapse, of which after PVP 11 cases, PKP 12 cases after operation, the incidence rate of PKP group was significantly higher than PVP group, the dif- ference was statistically significant （9.01% vs 20.69%, P〈0.05）. The gender, age, bone mineral density, af- ter injury to the baseline data of operation time, surgical segment between PVP group and PKP group showed no significant differences （P〉0.05）. The baseline data of patients with postoperative vertebral collapse again between the, two groups had no statistical differences （P〉0.05）. But the correction of vertebral height ratio, the anterior and middle vertebral between two groups had no significant differences （P〉0.05）.At last follow-up, the loss of vertebral height ratio, vertebral anterior and middle lost in PKP group were significantly higher than those of PVP group, the differences were statistically significant （P〈0.05）. Conclusion In the treatment of OVCF with bone cement filling technique, the incidence of vertebralcollapse in PKP operation is higher. During the operation, we should pay attention to the dispersion effect of bone cement, in order to achieve the uniform distribution in the vertebral body, in order to reduce the stress concentration, and avoid the occurrence of vertebral collapse after operation.

关 键 词：骨质疏松性椎体压缩性骨折 经皮椎体成形术 球囊扩张经皮椎体后凸成形术 伤椎塌陷 

分 类 号：R589[医药卫生—内分泌]