经皮椎体成形术和经皮后凸成形术治疗骨质疏松性椎体压缩骨折长期疗效的对比研究  

Comparison on long-term efficacy of percutaneous vertebroplasty versus percutaneous kyphoplasty on osteoporotic vertebral compression fractures

作　　者：赵楠 寇红伟[1] 尚国伟[1] 姬彦辉 陈松峰 陈向荣 包德明 程田[1] 郭俊杰[1] 李劲峰[1] 皮国富[1] 王义生[1] 刘宏建[1] Zhao Nan;Kou Hongwei;Shang Guowei;Ji Yanhui;Chen Songfeng;Chen Xiangrong;Bao Deming;Cheng Tian;Guo Junjie;Li Jinfeng;Pi Guofu;Wang Yisheng;Liu Hongjian(Department of Orthopaedics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院骨科,450052

出　　处：《中国实用医刊》2022年第3期1-5,共5页Chinese Journal of Practical Medicine

基　　金：河南省高等学校重点科研项目计划(16A320017);河南省医学科技攻关计划(201602002)。

摘　　要：目的观察经皮椎体成形术(PVP)和经皮后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCFs)的长期疗效。方法回顾性分析郑州大学第一附属医院2005年6月至2015年12月收治的680例OVCFs患者的临床资料,排除随访期间(随访时间>5年)死亡患者,最终纳入390例患者。根据治疗方式将患者分为PVP组(210例)和PKP组(180例)。比较两组患者的手术时间、骨水泥注入量和手术并发症;对比两组患者术前、术后3 d及末次随访时视觉模拟评分法(VAS)评分及伤椎的影像学变化。结果PVP组手术时间[(33.1±10.0)min]短于PKP组[(39.1±12.8)min],骨水泥注入量[(3.5±1.1)ml]少于PKP组[(4.8±1.2)ml],差异均有统计学意义(t=-5.592、-12.779,P均<0.01)。两组骨水泥渗漏率和相邻椎体骨折发生率比较差异未见统计学意义(P>0.05)。术后3 d及末次随访时,两组VAS评分均低于术前(P均<0.05),但两组间比较差异未见统计学意义(P>0.05)。PVP组和PKP组术后椎体高度分别较术前增加(3.9±2.3)、(5.6±2.6)mm,伤椎Cobb角分别较术前减小(4.2±2.3)°、(6.4±2.8)°,差异均有统计学意义(t=-7.069、-7.930,P均<0.01);两组末次随访时椎体高度及Cobb角丢失度比较差异均未见统计学意义(P均>0.05)。结论PVP和PKP均可以明显减轻OVCFs患者的疼痛症状,但PKP对于椎体高度的恢复和Cobb角的改善优于PVP;PVP与PKP治疗OVCFs均具有长期的有效性和安全性。Objective To observe the long-term effects of percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)on osteoporotic vertebral compressive fractures(OVCFs).Methods The clinical data of 680 OVCFs patients admitted to the First Affiliated Hospital of Zhengzhou University from June 2005 to December 2015 were retrospectively analyzed.Patients who died during follow-up(more than 5 years)were excluded,and 390 patients were finally included in the study.According to the treatment methods,the patients were divided into PVP group(210 cases)and PKP group(180 cases).The operation time,bone cement injection amount and surgical complications were compared between the two groups.The visual analogue scale(VAS)score and imaging changes of the injured vertebrae were compared between the two groups before operation,3 days after operation,and at the last follow-up.Results The operation time of the PVP group was(33.1±10.0)min,which was shorter than the(39.1±12.8)min of the PKP group,while the amount of bone cement injection of the PVP group was(3.5±1.1)ml,less than the(4.8±1.2)ml of the PKP group,and the differences were statistically significant(t=-5.592,-12.779;all P<0.01).There was no significant difference in the leakage rate of bone cement and incidence of adjacent vertebral fractures between the two groups(P>0.05).Compared with the preoperative scores,the VAS scores 3 day after the operation and at the last follow-up of the two groups were lower,and the differences were statistically significant(all P<0.05),but there was no significant difference between the two groups(P>0.05).The postoperative height of the vertebral body in the PVP group and the PKP group increased by(3.9±2.3)mm and(5.6±2.6)mm,respectively,and the Cobb angle of the injured vertebrae decreased by(4.2±2.3)°and(6.4±2.8)°,respectively,and the differences were statistically significant(t=-7.069,-7.930;all P<0.01);while there was no significant difference between the two groups in the loss of vertebral body height and Cobb angle at the last fol

关 键 词：骨质疏松症 经皮椎体成形术 经皮后凸成形术 随访 

分 类 号：R687.3[医药卫生—骨科学]