两种经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效比较  

Efficacy comparison of two types of percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture

作　　者：罗谨 李瑞龙 LUO Jin;LI Rui-long(Dept of Spinal Osteopathy and Joint Surgery,the People′s Hospital of Hezhou City,Hezhou,Guangxi 542899,China)

机构地区：[1]贺州市人民医院脊柱骨病关节外科,广西贺州542899

出　　处：《临床骨科杂志》2025年第2期153-156,共4页Journal of Clinical Orthopaedics

基　　金：广西壮族自治区贺州市科技局科学研究与技术开发计划项目(编号:贺科技2021029)。

摘　　要：目的比较单侧和双侧穿刺经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)的疗效。方法将68例OVCF患者根据穿刺方法不同分为单侧组(采用单侧穿刺PKP治疗,33例)和双侧组(采用双侧穿刺PKP治疗,35例)。比较两组手术情况、疼痛VAS评分、伤椎后凸Cobb角、伤椎前缘高度百分比、并发症发生情况、Qualeffo-41评分。结果患者均获得18个月随访。手术时间、术中透视时间、骨水泥注入量单侧组均短(少)于双侧组(P<0.05)。两组疼痛VAS评分和Qualeffo-41评分术后各时间点均较术前改善(P<0.05),两组间比较差异均无统计学意义(P>0.05)。术后3个月伤椎后凸Cobb角和伤椎前缘高度百分比均较术前改善(P<0.05),两组间比较差异均无统计学意义(P>0.05)。骨水泥渗漏率单侧组低于双侧组(P<0.05)。结论单侧和双侧穿刺PKP是治疗OVCF安全有效的方法,单侧穿刺PKP具有手术时间和术中透视时间较短、骨水泥注入量较少、骨水泥渗漏率较低的优点。Objective To compare the efficacy of unilateral and bilateral puncture percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fracture(OVCF).Methods The 68 patients with OVCFs were divided into unilateral group(33 cases were treated with unilateral PKP)and bilateral group(35 cases were treated with bilateral PKP).The surgical status,pain VAS,Cobb angle of the injured vertebrae,percentage of anterior margin height,incidence of complications and Qualeffo-41 score were compared between the two groups.Results All patients were followed up for 18 months.Operative time,intraoperative fluoroscopy time and bone cement injection volume were shorter(less)in unilateral group than those in bilateral group(P<0.05).The pain VAS and Qualeffo-41 scores of the two groups were improved at various time-points after surgery,compared with those before surgery(P<0.05),and there was no statistical significance between the two groups(P>0.05).The Cobb angle and percentage of anterior edge height of injured vertebrae were improved 3 months after surgery(P<0.05),and there was no statistical significance between the two groups(P>0.05).The bone cement leakage rate in unilateral group was lower than that in bilateral group(P<0.05).Conclusions Unilateral and bilateral PKP puncture are safe and effective method for the treatment of OVCF.Unilateral PKP puncture has the advantages of shorter operation time and intraoperative fluoroscopy time,less injection of bone cement and lower leakage rate of bone cement.

关 键 词：经皮椎体后凸成形术 单侧穿刺 双侧穿刺 骨质疏松性椎体压缩骨折 

分 类 号：R687.3[医药卫生—骨科学] R683.2[医药卫生—外科学] R681[医药卫生—临床医学]