球囊扩张与SKY扩张经皮椎体后凸成形术比较

The clinical application and comparison between balloon percutaneous kyphoplasty and "Sky-bone expander" percutaneous kyphoplasty

目的:比较球囊扩张与SKY扩张经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折的效果。方法:2004年6月～2008年6月应用Kyphon球囊和SKY扩张器行PKP治疗骨质疏松性椎体压缩骨折61例80个椎体,其中球囊组41例52个椎体,SKY组20例28个椎体。术前、术后和随访时行疼痛视觉模拟评分(VAS),并拍摄X线片测量伤椎高度、Cobb角等指标。结果:注射量:平均每椎2.5～6.5ml,球囊组4.5ml,SKY组4.0ml。两组患者术后VAS评分较术前都有明显下降(P<0.01),疼痛缓解在术后2～72h内,平均12h。术后两组伤椎前缘、中部、后缘高度恢复为1.7～2.9mm,恢复率为29.4%～48.8%;伤椎高度、后凸角及Cobb角两组均较术前恢复(P<0.01),但恢复度两组无显著性差异(P>0.05)。随访时伤椎高度无明显丢失,骨水泥未见松动。结论:球囊扩张与SKY扩张PKP治疗骨质疏松性椎体压缩骨折均能迅速缓解疼痛,并部分恢复椎体高度、矫正后凸畸形,球囊组灌注剂充填量稍多,但两组复位情况无显著性差异。

Objective： To evaluate and compare the clinical results of balloon percutaneous kyphoplasty （PKP） and ＂SKY-bone expander＂ PKP. Methods： From 2004 to 2008,61 cases with 80 osteoporotic vertebral compressive fractures （OVCF）underwent PKP. Among them 41 cases with 52 vertebral bodies underwent the Kyphon balloon-PKP,20 cases with 28 vertebral bodies underwent the SKY-PKP. The clinical effect was evaluated by observing the changes of visual analog scale （VAS）, the height reposition of vertebral body and the kyphosis （Cobb＇ angle） etc. Results： The average quant of PMMP in one vertebra ware 4.5 ml in baloon-PKP and 4.0 ml in SKY-PKP. Postoperative VAS scores of the both groups decreased obviously compared with those of preoperation （P 〈 0.01）. The both groups had significant difference （P 〈 0.01） in restoration of vertebra height, kyphosis and Cobb＇s angle improvement in postoperation compared with those in preoperation, but there was no significant difference （P 〉 0.05） in improved degree between balloon-PKP and SKY-PKP. The average correction of the both groups of anterior height, midline height and posterior height were 1.7 ~2.9 mm. When follow up, the height of vertebra did not lost visibly and the PMMP did not disperse. Conclusion： The balloon-PKP and SKY-PKP not only could provide the OVCF patients faster pain relief and expedite their return to function, but also restore the vertebra height and improve the kyphosis partly. The balloon-PKP dose not better than SKY- PKP on the restoration of vertebra height and kyphosis improvement.