双侧经皮椎体后凸成形术与经皮椎体成形术治疗Kummell的临床效果比较

Clinical Comparison of Bilateral Percutaneous Kyphoplasty and Percutaneous Vertebroplasty for Kummell

目的探究双侧经皮椎体后凸成形术与经皮椎体成形术治疗Kummell的临床效果.方法选取2018年1月—2020年6月兰陵县人民医院收治的92例Kummell病患者,将行经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗的46例患者作为对照组,将行经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗的46例患者作为观察组.记录两组患者的各项术中指标,并比较术前1 d(T0)、术后1 d(T1)、术后1个月(T2)、术后6个月(T3)时两组患者的疼痛视觉模拟评分(visual analogue scale,VAS),Oswestry功能障碍指数(Oswestry disability index,ODI),椎体后凸角(Cobb角)纠正效果.结果观察组的手术时间、骨水泥量及X线透射次数均明显高于对照组,骨水泥渗漏例数及渗漏率明显低于对照组,组间差异有统计学意义(P<0.05).两组T1~T3各时点的VAS评分、ODI指数、Cobb角度数均明显低于各组T0时,差异有统计学意义(P<0.05);但观察组T0~T3各时点的VAS评分、ODI指数、Cobb角度数与对照组同时点比较,差异无统计学意义(P>0.05).结论PVP及PKP治疗I型、II型Kummell病患者均具有良好的效果,均可显著缓解患者疼痛,改善日常功能障碍,纠正Cobb角.临床应综合考虑患者年龄、病情、骨质疏松程度及经济承受能力等进行术式选择,并制定个体化治疗方案.

Objective To investigate the clinical effect of bilateral percutaneous kyphoplasty and percutaneous vertebroplasty in the treatment of Kummell.Methods The clinical data of 92 patients with Kummell's disease admitted to Lanling County People's Hospital from January 2018 to June 2020 were retrospectively analyzed.46 patients who underwent percutaneous vertebroplasty(PVP)were enrolled as the control group,and 46 patients who underwent percutaneous kyphoplasty(PKP)were enrolled as the observation group.All intraoperative indicators of patients in the two groups were recorded,and the pain visual analogue scale(VAS)score,Oswestry disability index(ODI),vertebral kyphosis angle(Cobb angle)correction effect at 1 day before surgery(T0),1 day after surgery(T1),1 month after surgery(T2),and 6 months after surgery(T3)were compared between the two groups.Results The operation time,bone cement amount and X-ray transmission times of the observation group were significantly higher than those of the control group,and the number of bone cement leakage cases and leakage rate were significantly lower than those of the control group,the differences between the groups were statistically significant(P<0.05).The VAS scores of the two groups of T1 to T3,the ODI index,the number of COBB angles were significantly lower than that of each group of T0,and the difference was statistically significant(P<0.05);but the observation group T0~T3 VAS score The ODI index,the number of COBB angles and the control group were compared at the same time,and there was no statistical significance(P>0.05).Conclusion PVP and PKP have good effects on Kummell's patients with type I and II,which can significantly relieve pain,improve daily dysfunction and correct Cobb angle.In clinical practice,patients'age,condition,degree of osteoporosis and economic affordability should be taken into consideration for surgical selection,and individualized treatment plan should be formulated.