单侧与双侧入路椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的临床研究

The randomized controlled study of unilateral versus bilateral percutaneous kyphoplasty for the treatment of elderly osteoporotic vertebral compression fractures

目的探讨经单侧与双侧穿刺椎体后凸成形术治疗骨质疏松性椎体压缩性骨折临床疗效。方法选取我院2007-01-2010-12收治的骨质疏松性椎体压缩性骨折患者80例,随机分为单侧穿刺组与双侧穿刺组,观察两组手术时间、X线机曝光次数、出血量、骨水泥量、手术前后VAS评分变化、椎体平均高度、局部Cobb角改善、骨水泥渗漏及椎体再骨折发生情况。结果单侧组在平均手术时间、平均骨水泥注入量、平均出血量及X线曝光次数上均较双侧组少。两组术后及末次随访时VAS评分均较术前明显降低,术后两组椎体平均高度及局部Cobb角较术前均有显著恢复,组间比较无显著性差异;两组在骨水泥渗漏及邻近椎体再骨折的发生率比较无显著性差异。结论经单侧椎弓根途径穿刺骨水泥过椎体中线注射治疗骨质疏松性椎体压缩骨折可取得双侧穿刺同样满意的临床效果。

Objective To evaluate the efficacy of unilateral versus bilateral percutaneous kyphoplasty （PKP） for osteoporotic vertebral compression fractures （OVCFs）. Methods 80 cases who sustained osteoporotic vertebral compression fracture from January 2007 to December 2008 were divided into two groups according to unilateral or bilateral approach by the randomized con-trolled study. The operation time,amount of bleeding,X ray exposure times,anterior and middle vertebral height restoration,VAS scores improvement and complications at final follow-up after op-eration between unilateral and bilateral PKP were compared. Results The two groups have statis-tically significant differences in mean operative time,average X-ray,exposure times,amount of bleeding. The VAS score decreased significantly after operation in two groups, but no significant difference was noted between two groups. Both two groups had significant recovery of average vertebral height and local Cobb＆#39;s angle,but had no statistically significant differences. The rate of cement leakage and adjacent vertebral fractures had no statistically significant differences between the two groups. Conclusion Unilateral and bilateral PKP is a reliable and effective treatment for OVCFs.