单双侧椎体后凸成形术治疗骨质疏松性胸腰椎压缩骨折的疗效分析

Curative effect analysis of unipedicular and bipedicular percutaneous kyphonplasty for the osteoporotic thoracolumbar compressed fracture

目的对比单双侧椎体后凸成形术(PKP)治疗骨质疏松性单一胸腰椎压缩骨折的临床疗效。方法回顾性分析自2010-06—2013-04北京积水潭医院脊柱科诊治的PKP患者451例,分为单侧和双侧入路组。评价指标:手术时间、透视次数、骨水泥量、VAS评分、椎体高度、Cobb角及骨水泥渗漏。结果所有患者均顺利完成手术。平均手术时间、骨水泥填充量、平均手术时间、骨水泥注射量、X线曝光时间2组比较,差异有统计学意义(P<0.05)。2组术后VAS评分、平均椎体高度、Cobb角较术前显著改善,差异有统计学意义(P<0.05)。2组骨水泥渗漏率相似,差异无统计学意义(P>0.05)。结论单侧入路行PKP治疗骨质疏松性单椎体骨折比双侧入路具有手术时间更短、X线放射次数更少等优点,能取得经双侧入路穿刺相似的治疗效果。

Objective To compare effect of unipedicular and bipedicular percutaneous kyphonplasty（PKP） for treatment of osteoporotic thoracolumbar compression fractures. Methods The clinical data of 451 patients were reviewed retrospectively,who were treated with PKP for osteoporotic thoracolumbar vertebral compression fractures from June 2010 to April 2013 in department of spine of Jishuitan hospital in Beijing. All cases were divided into two groups according to unipedicular and bipedicular PKP. Evaluation indicators included the average operation time, average number of X-ray, the volume of bone cement, VAS（visual analogue scale） scores before and after the operation, height of vertebral body and Cobb angle of pre- and post-operation and the complications of the bone cement leakage. Results All patients were successfully operated. Statistical analysis results showed significant difference between the two groups,in the mean operative time, the volume of bone filling cement, the average operation time, the volume of bone cement injection, the times of X-ray exposure（ P 〈0.05）. In both two groups, postoperative VAS scores, average vertebral height and the local Cobb angle recovered significantly than before surgery（P 〈0.05）. The two groups had similar rates of bone cement leakage（P 〉0.05）. Conclusion The unipedicular kyphoplasty for treatment with osteoporotic fractures has shorter operation time and X-ray time than the bipedicular approach,and it could achieve similar effect as bipedicular approach.