经皮椎体后凸成形术与经皮椎体成形术治疗骨质疏松性椎体压缩骨折的疗效对比  

Comparison of PVP and PKP in the Treatment of OVCF

作　　者：张善成[1] ZHANG Shan-cheng(Shangshui people's Hospital,Zhoukou Henan 466100)

机构地区：[1]商水县人民医院,河南周口466100

出　　处：《医学临床研究》2021年第5期740-742,746,共4页Journal of Clinical Research

摘　　要：【目的】比较经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)与经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)患者的临床疗效。【方法】选取76例OVCF患者,按照手术方式不同分为PKP组(41例)与PVP组(35例),比较两组临床疗效。【结果】两组患者术后椎体前缘高度均显著高于术前,后凸Cobb角和视觉模拟评分(VAS)均显著低于术前(P<0.05),且PKP组优于PVP组。与治疗前比较,两组患者治疗后1个月Oswestry功能障碍指数(ODI)评分均显著下降,日本骨科协会(JOA)下腰痛评分均显著提高(P<0.05),且PKP组变化更为明显(P<0.05);相比PVP组,PKP组骨水泥渗漏率下降,而平均骨水泥注入量和治疗费用增多(P<0.05)。两组邻近椎体骨折发生率和术后VAS评分比较差异均无统计学意义(P>0.05)。【结论】PKP与PVP均可安全、有效改善OVCF患者临床疗效,减轻患者痛苦,但相比PVP,虽PKP治疗费用相对较高,但可更好地恢复椎体形态、提高椎体高度、降低骨水泥渗漏的发生,临床可根据患者的实际情况选取合适的手术方式。[Objective]To compare the clinical efficacy of percutaneous kyphoplasty(PKP)and percutane-ous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fractures(OVCF).【Meth-ods】A total of 76 patients with OVCF were divided into the PKP group(41 cases)and the PVP group(35 cases)according to different operation methods.Clinical efficacy was compared between the two groups.【Results】Compared to before operation,the height of anterior vertebral body in both groups were higher after op eration,and the kyphosis Cobb angle and visual analogue scale(VAS)were lower(P<0.05).Compared to before treatment,the Oswestry disability index(ODI)scores of the two groups decreased significantly 1 month after treatment,and the Japanese Orthopaedic Association(JOA)low back pain scores increased significantly(P<0.05).Compared to the PVP group,ODI scores of the PKP group decreased significantly,and the JOA scores increased significantly(P<0.05).Compared to the PVP group,the PKP group had higher anterior vertebral height,lower kyphosis Cobb angle,lower bone cement leakage rate,and higher bone cement injection volume and average treatment cost(P<0.05).There was no significant difference in the incidence of adjacent vertebral fracture and postoperative VAS score between the two groups(P>0.05).[Conclusion】Both PKP and PVP can safely and effectively improve the clinical efficacy of OVCF patients and relieve the pain of patients.Compared to PVP,PKP has higher treatment cost,but it can better restore the vertebral shape»improve the vertebral height,and reduce the occurrence of bone cement leakage.

关 键 词：骨质疏松/并发症 脊柱骨折/病因学 脊柱骨折/外科学 椎体成形术/方法 椎体后凸成形术/方法 

分 类 号：R683[医药卫生—骨科学]