过伸复位联合经皮球囊扩张椎体后凸成形术治疗骨质疏松型椎体压缩骨折

Application of hyperextension reset combined with percutaneous kyphoplasty in the treatment of osteoporotic vertebral body compression fracture

目的观察过伸复位结合经皮球囊扩张椎体后凸成形术（PKP）治疗骨质疏松型椎体压缩骨折（OVCF）的临床疗效。方法将60例OVCF患者随机分为两组，观察组30例（病椎体38个）采用过伸复位结合PKP治疗；对照组30例（病椎体34个）采用经皮椎体成形术（PVP）治疗，比较两组手术前后的疗效、椎体前缘高度的恢复情况、并发症发生率。结果术后3d观察组患者的骨水泥渗漏率显著低于对照组（P〈0．05），骨水泥CT平面分布面积及骨水泥平均注射量显著多于对照组（P〈0．05）；术后1、6、12个月，观察组患者椎体高度压缩率、Cobb’S角均显著小于对照组（P〈0．05或P〈0．01）。结论在恢复椎体高度、减小后凸畸形和减少骨水泥渗漏方面，过伸复位结合PKP明显优于PVP。

Objective To observe the clinical effect of hyperextension reset combined with percutaneous kyphoplasty （PKP） on osteoporotic vertebral body compression fracture （OVCF）. Methods Sixty cases of OVCF were randomly divided into two groups, 30 cases（38 pathological vertebraes） in the observation group were treated by hyperextension reset combined with PKP therapy; 30 cases （34 pathological vertebraes） in the control group were treated by percutaneous vertebroplasty （PVP） therapy. The efficacy, the recovery situation of anterior vertebral height, the incidence of complications before and after surgery were observed and compared between the two groups. Results Three days after surgery, the bone cement leakage rate in the observation group were significantly lower than that in the control group （P 〈 0.05）, the bone cement CT horizontal distribution area and the average bone cement injection volume in the observation group were significantly more than those in the control group （P all 〈 0.05） ; 1,6,12 months after surgery, the vertebral height compression ratio and the Cobb angle in the observation group were significantly smaller than those in the control group （P 〈 0.05 or P 〈 0.01 ）. Conclusions Hyperextension reduction combined with PKP is superior to PVP in the recovery of the vertebral height, the reduction of the kyphotic deformity and the leakage of bone cement.