对比经皮椎体成形术和经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床疗效  

Comparison of percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures

作　　者：李建华 周仕国 林世水 刘国铭 陈昱 LI Jian-hua;ZHOU Shi-guo;LIN Shi-shui(Fujian Provincial Jinshan Hospital, Fuzhou 350001 , China)

机构地区：[1]福建省立金山医院,福建福州350001

出　　处：《吉林医学》2019年第3期521-524,共4页Jilin Medical Journal

摘　　要：目的:对比经皮椎体成形术和经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床疗效。方法:回顾性分析采用经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)治疗的骨质疏松性椎体压缩骨折68例,其中30例采用PVP手术治疗为PVP组,38例采用PKP手术治疗为PKP组。记录手术时间、透视次数、骨水泥渗漏发生率和骨水泥灌注量;于术前和术后12个月记录VAS评分、ODI指数、Cobb角、椎体前缘百分比以及末次随访时进行Macnab疗效评价。结果:①PVP组的手术时间和透视次数显著少于PKP组,差异有统计学意义(P<0.05);骨水泥渗漏发生率显著高于PKP组,差异有统计学意义(P<0.05);而两组的骨水泥灌注量差异无统计学意义(P>0.05)。②与术前比较,术后两组的VAS评分和ODI指数均显著下降,差异有统计学意义(P<0.05);术后两组的VAS评分和ODI指数差异无统计学意义(P>0.05)。③与术前比较,术后两组的Cobb角显著下降,差异有统计学意义(P<0.05),椎体前缘百分比显著增高,差异有统计学意义(P<0.05);术后PKP组的Cobb角显著低于PVP组,差异有统计学意义(P<0.05),椎体前缘百分比显著高于PVP组,差异有统计学意义(P<0.05);两组的Macnab疗效等级评价差异无统计学意义(P>0.05)。结论:PVP手术和PKP手术均可有效治疗骨质疏松性椎体压缩骨折,PVP的优势在于手术时间短和透视次数少,PKP的优势在于更好地恢复椎体高度和稳定性,较少发生骨水泥渗漏。Objective To compare the clinical efficacy of percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures. Method Retrospective analysis of 68 cases of osteoporotic vertebral compression fracture treated by percutaneous vertebroplasty ( PVP) and percutaneous kyphoplasty ( PKP), of which 30 cases were treated with PVP and 38 cases were treated by PKP operation as PKP group. The operation time , the frequency of fluorosco py ,the incidence of cement leakage and the quantity of bone cement were recorded. The VAS score , the ODI index , the Cobb angle , the percentage of the anterior edge of the vertebral body and theevaluation of theMacnab were recorded at thel 2 months after surgery- Results ①The operation time and the frequency of fluoroscopy in group PVP were significantly less than that in group PKP ( P < 0. 05 ), and the rate of bone cement leakage was significantly higher than that in group PKP ( P < 0. 05 ), but there was no difference in the amount of bone cement perfusion in the two groups ( P > 0. 05 ).②Compared with the preopera tive ,the VAS score and the ODI index of the two groups were significantly decreased (P <0. 05), and there was no difference between the two groups, VAS scores and the ODI index (P >0. 05).③Compared with pre operation , the Cobb angle of two groups decreased significantly ( P < 0. 05 ), the percentage of anterior edge of vertebral body increased significantly ( P < 0. 05 ), Cobb angle in group PKP was significantly lower than that in group PVP ( P < 0. 05 ), and the percentage of anterior margin of vertebral body was significantly higher than that of PVP group ( P < 0. 05 ), and there was no difference in the evaluation of the curative effect between the two groups ( P > 0. 05 ). Conclusion PVP operation and PKP operation can effectively treat osteoporotic vertebral compression fracture. The advantage of PVP is short operation time and few fluoroscopy times. The advantage of PKP is to better restore the height and

关 键 词：骨质疏松性压缩性骨折 经皮椎体成形术 经皮椎体后凸成形术 回顾性分析 

分 类 号：R687.3[医药卫生—骨科学]