单球囊与双球囊后凸成形术对椎体复位作用的研究

The contrast study between single and double balloon bilateral dilatation of kyphoplasty

目的探讨单球囊与双球囊后凸成形术对椎体压缩骨折复位作用的差异,评价后凸成形术的临床疗效。方法对2000年5月～2004年5月应用球囊扩张后凸成形术(KP)施行椎体复位的58例胸腰椎椎体压缩性骨折(VCFs)患者(90个椎体)的临床资料进行了回顾性分析。58例患者90个椎体分为单球囊组(28个椎体)和双球囊组(62个椎体),两组均经双侧椎弓根穿刺,扩张后灌注骨水泥,分别采用单球囊双侧交替扩张和双球囊双侧同时扩张的方法。分别测量术前术后椎体高度和Cobb角,比较术前术后及两组之间的差异。结果患者术后疼痛均明显减轻或消失。椎体高度平均恢复率726%(229～100%);Cobb角由术前179°(31°～316°)矫正至术后96°(06°～282°),平均矫正87°(03°～272°),术前、术后相比差异有极显著性意义(P<0001)。单球囊组和双球囊组术后椎体高度平均恢复率分别为776%(553%～100%)和643%(229%～100%),术后平均矫正Cobb角分别为99°(03°～272°)和86°(06°～198°),两组相比差异无显著性意义(P>005)。结论后凸成形术可有效缓解椎体压缩骨折患者的疼痛,恢复椎体高度,改善后凸畸形;单球囊与双球囊后凸成形术同样能使压缩骨折的椎体获到较好复位。

Objective To contrast single and double balloon inflated kyphoplasty for vertebral compression fractures (VCFs) and evaluate its clinical efficacy. Methods From May 2000 to May 2004, 90 consecutive procedures were performed in 58 patients who suffered from painful vertebral compression fractures, transferring tumour and angioma. Ninety vertebrae were inflated while 62 as A group were double balloon and 28 as B group were single balloon, fracture reduction and bone cement augmentation. Preoperative and postoperative symptom levels, variables, complications were recorded and the vertebral height and Cobb angle were measured and analyzed. Results All patients′ pain was alleviated or disappeared without syndrome, and the vertebral height and Cobb angle of both groups were improved. The average recovery rate was 72 6% (22.9%～100%), Cobb angle from 17 9°(3.1°～31.6°) were corrected to 9 6°(0.6°～28.2°), the average angle was 8 7°(0.3°～27.2°) , and the contrast between preoperative and postoperative showed obvious differences ( P <0 001). The average recovery rate of A group was 77 6%(55 3%～100%) , B group was 64 3%(22 9%～100%). The average postoperative Cobb angle of A group was 9 9°(0 3°～27 2°), B group was 8 6°(0 6°～19 8°) ( P >0 05). Conclusions As a promising minimally invasive surgery, balloon kyphoplasty can provide early relief of pain and improve the function as well as spinal alignment in treatment of painful compression fracture owing to recovering the vertebral height and Cobb angle of the vertebral body. Single balloon inflated kyphoplasty can improve VCFs as double balloon.