单侧PKP治疗骨质疏松性椎体压缩骨折对手术对侧椎体骨密度的影响

Effect of unilateral percutaneous kyphoplasty on the bone mineral density of contralateral side

目的：探讨经单侧椎弓根穿刺行经皮椎体后凸成形术（percutaneouskyphoplasty，PKP）对手术对侧椎体骨密度（bonemineraldensity，BMD）的影响。方法：对2010年6月～2012年8月在我院行单侧PKP手术治疗的30例骨质疏松性椎体压缩骨折（osteoporoticvertebralcompressionfractures，OVCF）患者的30个椎体的骨密度进行分析。男5例，女25例．年龄66～86岁：骨折椎体压缩程度不超过70％。均为经左侧椎弓根单侧手术注入骨水泥。所有患者术前常规行骨密度测量和骨折椎体右侧半椎体骨密度测量，术后72h内行骨折椎体右侧半椎体去假体骨密度、含假体骨密度测量，应用SPASS16．0软件采用配对t检验对术前和术后骨密度结果进行统计学分析。结果：所有病例均成功完成手术，骨水泥部分弥散至对侧，术中和术后无严重并发症发生。术前右侧半椎体密度值为0．6705±0．0677g/cm2，术后右侧半椎体含假体骨密度值为1．123±0．1942g／cm2，术前与术后含似体骨密度差值为0．4525±0．2236g／cm2；术后去假体骨密度值为0．7717±0．0776g／cm2，术前与术后去假体骨密度差值为0．1012±0．0672g／cm2，差异有显著性（P〈0．001）。结论：单侧PKP治疗骨质疏松性椎体压缩骨折在骨水泥部分弥散至对侧的情况下，可提高对侧椎体骨密度，从而降低再骨折风险。

Objectives： To explore the effect of unilateral percutaneous kyphoplasty（PKP） on the bone mineral density（BMD） of eontralateral side. Methods： The BMD of 30 patients including 5 males and 25 females ag- ing from 66 to 86 years and suffering fi＇om osteoporotie vertebral compression fractures underwent unilateral PKP in our hospital from June 2010 to August 2012. The compression degree of all fractures did not exceed 70%. Preoperative lumbar BMD and BMD of the right half of vertebrae were measured in all cases routinely, while BMD of the right half of vertebrae （containing and removing prosthesis） was measured postoperatively, SPASS 16.0 software was applied by a paired t test for statistical processing. Results： All patients underwent surgery successfully, part of the cement diffused to the eontralateral side. There were no serious complications noted during or after operations. Preoperative and postoperative BMD of the right half of vertebrae （bone ce- ment retaining） was 0,6705±0.0677g/cm2 and 1.123±0.1942g/cm2 respectively, with a mean difference of 0.4525±0.2236g/cm2（P〈0.001）, which showed significant difference. Postoperative and preoperative BMD of the right half of vertebrae（bone cement absent） was 0.7717±0.0776g/cm2 and 0.1012±0.0672g/cm2, which showed significant difference（P〈0.001）. Conclusions： Unilateral PKP can improve the BMD of contralateral side of the vertebrae based on partial bone cement diffusing to the contralateral side, which can reduce the risk of onset of fractures.mineral density