椎体后凸成形术中单球囊交替扩张与双球囊同时扩张治疗骨质疏松性椎体骨折的疗效对比

Comparison of clinical effect of percutaneous kyphoplasty with one balloon alternating expansion and two balloons meanwhile expansion in treating osteoporotic vertebral compressive fractures

目的对比单球囊交替扩张与双球囊同时扩张椎体后凸成形术(PKP)治疗骨质疏松性椎体骨折的临床疗效。方法 54例骨质疏松性椎体骨折患者,按手术方法不同分为单球囊组(30例)和双球囊组(24例),对比两组患者的手术时间、术中出血量、骨水泥注射量及疼痛视觉模拟评分(VAS)、Cobb角、椎体高度,评价其疗效。结果单个椎体手术时间、骨水泥注射量及术中出血量两组比较差异均无统计学意义(P>0.05);手术前后VAS评分、Cobb角及椎体前缘高度、中央高度及后缘高度两组比较差异均无统计学意义(P>0.05)。两组术后VAS评分及Cobb角均较术前明显改善(P<0.05);两组术后椎体前缘高度与中央高度均较术前提高(P<0.05),但后缘高度并未发生明显的变化(P>0.05)。结论单球囊交替扩张与双球囊同时扩张PKP治疗骨质疏松性椎体骨折均能够获得较好的疗效,但在患者经济情况允许的情况下,双球囊扩张术应是首选术式。

Objective To compare the clinical effect of percutaneous kyphoplasty with one balloon alternating expansion and two balloons meanwhile expansion in treating osteoporotic vertebral compressive fractures. Methods 54 cases of patients with osteoporotic vertebral fractures, according to different surgical methods, were divided into a single balloon group （30 cases） and double-balloon group （24 cases）, compared two groups of patients with surgical times, blood loss,bone cement injection volume and pain visual analogue scale （VAS）, Cobb angle, vertebral height,in order to evaluate the clinical effect. Results The single vertebral operative time, blood loss, bone cement injection volume and the amount of the difference was not statistically significant between two groups （P 〉 0. 05 ） ; For before and after surgery VAS scores, Cobb angle and vertebral height, central height and after edge height difference was not statistically significant in two groups（P 〉0.05） ; Two groups patients of postoperative Cobb angle, VAS scores were significantly improved （ P 〈 0. 05 ） ; postoperative anterior vertebral height in both height and central increased （ P 〈 0. 05）, but not posterior height changed significantly （P 〉 0. 05 ）. Conclusions Percutaneous kyphoplasty with one balloon and two balloons both have a significant effect in treating osteoporotic vertebral compressive fractures. However, in the case of patients with the good economic situation, two-balloon dilation is the preferred technique.