经皮椎体成形术与椎体后凸成形术治疗老年胸腰椎椎体压缩性骨折的临床疗效和安全性比较  

Comparison of Clinical Efficacy and Safety of Percutaneous Vertebroplasty and Kyphoplasty in the Treatment of Thoracolumbar Vertebral Compression Fractures in the Elderly

作　　者：程荣 杨海 魏加树 周洪刚 王懿 CHENG Rong;YANG Hai;WEI Jiashu;ZHOU Honggang;WANG Yi(Department of Orthopedics,Lianshui Hospital of Traditional Chinese Medicine,Lianshui 223400,Jiangsu,China)

机构地区：[1]涟水县中医院骨科,江苏涟水223400

出　　处：《系统医学》2025年第5期154-156,160,共4页Systems Medicine

摘　　要：目的探讨老年胸腰椎椎体压缩性骨折分别采取经皮椎体成形术(percutaneous vertebro plasty,PVP)与椎体后凸成形术(percutanous kyphoplasty,PKP)治疗的效果。方法非随机选取涟水县中医院于2021年4月—2024年4月收治的82例老年胸腰椎椎体压缩性骨折患者为研究对象,按治疗方法分为两组,各41例。对照组治疗方案为PVP,观察组治疗方案为PKP。对两组手术相关指标、疼痛评分与影像学参数、骨水泥渗漏率进行比较分析。结果观察组手术时间为(42.61±6.57)min,较对照组的(35.73±5.24)min更长;透视次数为(25.46±3.84)次、骨水泥注入量为(5.14±0.67)mL,较对照组的(20.37±3.21)次、(3.61±0.45)mL更多,差异有统计学意义(t=5.242、6.512、12.138,P均<0.05)。术后观察组疼痛评分、伤椎后凸角低于对照组,前缘高度大于对照组,差异有统计学意义(P均<0.05)。观察组骨水泥渗漏率为4.88%(2/41),对照组骨水泥渗漏率为19.51%(8/41),观察组低于对照组,差异有统计学意义(χ^(2)=4.100,P=0.043)。结论PKP治疗老年胸腰椎椎体压缩性骨折时手术时长较PVP略长,但PKP在术后伤椎功能恢复、疼痛减轻、骨水泥渗漏风险和安全性方面优于PVP。Objective To investigate the effect of percutaneous vertebro plasty(PVP)and percutanous kyphoplasty(PKP)in the treatment of thoracolumbar vertebral compression fractures in the elderly.Methods A total of eighty-two elderly patients with thoracolumbar vertebral compression fractures admitted to Lianshui Hospital of Traditional Chinese Medicine from April 2021 to April 2024 were non-randomly selected as the research objects and divided into two groups according to the treatment method,with forty-one cases in each group.The control group was treated with PVP,and the observation group was treated with PKP.The operation related indexes,pain score,imaging parameters and bone cement leakage rate of the two groups were compared and analyzed.Results The operation time of the observation group was(42.61±6.57)min,which was longer than the control group(35.73±5.24)min,the number of fluoroscopy was(25.46±3.84)times and the amount of bone cement injection was(5.14±0.67)mL,which were more than(20.37±3.21)times and(3.61±0.45)mL of the control group,and the differences were statistically significant(t=5.242,6.512,12.138,all P<0.05).After operation,the pain score and kyphosis angle of the injured vertebra in the observation group were lower than those in the control group,and the height of the anterior edge was higher than that in the control group,the differences were statistically significant(all P<0.05).The bone cement leakage rate of the observation group was 4.88%(2/41),and the bone cement leakage rate of the control group was 19.51%(8/41).The observation group was lower than the control group,and the difference was statistically significant(χ^(2)=4.100,P=0.043).Conclusion The operation time of PKP in the treatment of thoracolumbar vertebral compression fractures in the elderly is slightly longer than that of PVP,but PKP is superior to PVP in postoperative functional recovery of injured vertebrae,pain relief,risk of bone cement leakage and safety.

关 键 词：经皮椎体成形术 椎体后凸成形术 胸腰椎 椎体压缩性骨折 安全性 

分 类 号：R68[医药卫生—骨科学]