经皮椎体后凸成型术与椎弓根螺钉系统治疗胸腰段椎体压缩性骨折的临床疗效比较

Comparison of clinical effectiveness of percutaneous kyphoplasty vs pedicle screw system in the treatment of vertebral compression fracture

目的比较经皮椎体后凸成型术与椎弓根螺钉系统治疗胸腰段椎体压缩性骨折的临床疗效。方法收集我科2003年9月至2005年12月手术治疗的86例胸腰段椎体压缩性骨折患者,根据手术方法不同分为A组(椎体后凸成型术组)和B组(椎弓根螺钉固定组)。A组30例,B组56例,比较两组术前术后椎体前缘、中线、后缘高度变化,疼痛视觉模糊评分(visual analogue painscale,VAS),手术时间,出血量等方面的差异。结果两组对椎体高度的恢复比较没有统计学意义,A组的手术时间和出血量较B组少,差异有统计学意义(P<0.01),VAS A组较B组小(P<0.01)。结论经皮椎体后凸成型术与椎弓根螺钉系统具有相当的治疗椎体压缩性骨折效果,且经皮椎体后凸成型术具有创伤小、手术时间短、出血量少等微创优点。

Objective To compare the clinical efficacy of percutaneous kyphoplasty （PKP）vs pedicle screw system in the treatment of vertebral compression fracture. Methods Eighty - six patients with vertebral body compression fracture, who underwent operation with PKP and pedicle screw system, were collected. All patients were assigned into group A （PKP group） and group B （pedicle screw group）. In group A, there were 12 males and 18 females with average age of 65 years （42～78 years）,while in group B,there were 24 males and 32 females with average age of 61 years （36～72 years）. The anterior height,midline height and posterior height of vertebrae body,visual analogue pain scale （VAS）preoperatively and postoperatively,operative time and amount of blood loss were measured and compared between two groups.Result No statistically significant difference was noted in vertebral height reduction between two groups, but there was significant difference in the VAS（ P 〈 0. 01）,operative time and amount of blood loss（ P 〈0.01）between two groups.Conclusion PKP has the similar clinical effectiveness with pedicle screw system in the treatment of vertebral body compression fracture, and has the characterization of minimal invasion, shorter operative time and less blood loss.