单侧与双侧经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的疗效比较

Efficacy comparison of the effect on unipedicular versus bipedicular percutaneous kyphoplasty for osteoporotic vertebral compression fractures

目的比较单侧与双侧经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩性骨折(OVCFs)的临床疗效。方法 60例胸腰椎OVCFs患者分为两组,采用单侧PKP治疗31例38椎(单侧组)、双侧PKP治疗29例34椎(双侧组);比较两组术前、术后和术后6个月疼痛视觉模拟评分(VAS)、Cobb角及椎体高度、手术时间、X线照射时间及骨水泥注射量等,评价疗效。结果 60例患者均获随访,时间3～15(9.6±1.2)个月。患者疼痛均明显缓解;两组VAS评分、椎体Cobb角度、椎体前缘高度的恢复情况与术前比较,差异均有统计学意义(P<0.05);但两组间比较差异无统计学意义(P>0.05)。双侧组手术时间、X线照射时间及骨水泥用量均大于单侧组(P<0.05)。结论单侧PKP与双侧PKP治疗OVCFs疗效相似;但单侧PKP具有创伤小、手术时间短、放射暴露少、风险小等优点,应是治疗OVCFs的优先选择。

Objective To compare the clinical effect of unipedicular versus bipedicular percutaneous kyphoplasty （PKP） in the treatment of osteoporotic vertebral compression fractures（OVCFs）. Methods Sixty patients with thoracic and lumbar OVCFs were operated via unipedicular （31 cases,38 segments） or bipedicular （29 cases,34 seg- ments） PKP. The clinical effects were evaluated by visual analogue pain scale, Cobb＇s angle and the height of verte- bral bodies in preoperation, postoperation and 6 months ＇after operation, operation time, X-ray radiation exposure time and bone cement injection volume. Results Sixty patients were followed up for 3 - 15 （9. 6 ± 1.2） months. The VAS scores, Cobb＇s angle and the restoration of vertebral height in the postoperation were better than that in the preoperation each group（ P 〈 0. 05 ）. But there were no statistical difference between two groups（ P 〉 0.05 ）. The operation time, X-ray radiation exposure time and bone cement injection volume in the unipedicular group were less than the bipedicular group （ P 〈 0. 05 ）. Conclusions It is similar for clinical effects between unipedicular and bipedicular PKP in treatment of OVCFs. Compared with tile bipedicular group, the unipedicular group can reduce operation time, X-ray radiation exposure time and bone cement iniection volume, which is preference for the treatment of OVCFs.