PVP与PKP治疗骨质疏松性压缩骨折的早期疗效

Short-term efficacy of kyphoplasty and vertebroplasty in treatment of painful osteoporotic vertebral compression fractures

目的比较经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)的早期疗效。方法 OVCF患者85例,分别采用PVP(A组,40例)和PKP(B组,45例)治疗。比较两组VAS疼痛评分及Oswestry功能障碍指数(ODI)评分;手术前后X射线测量伤椎高度恢复率、受伤节段后突矫正率、骨水泥渗漏发生率及相邻椎体再发骨折情况。结果两组患者术后VAS疼痛评分及ODI评分均优于术前(P<0.05)。术后12个月,A组伤椎前壁、中间、后壁相对高度分别增高13.7%、11.0%和3.8%,少于B组的19.3%、23.9%和7.9%(P<0.05)。术后B组后突角较A组降低(P<0.05)。A组骨水泥渗漏率高于B组(34.6%vs.9.1%)(P<0.05)。两组患者相邻椎体再发骨折发生率无统计学差异(P>0.05)。结论 PVP和PKP均能在早期有效缓解OVCF患者的疼痛、改善生活质量;PKP对椎体高度恢复及后突畸形的矫正优于PVP,骨水泥渗漏率也较低。

Objective To compare the efficacy of kyphoplasty（PKP） and vertebroplasty（PVP） in the treatment of painful osteoporotic vertebral compression fractures（OVCF）. Methods A total of 85 patients with painful OVCF was treated with PVP（group A, 40 cases） and PKP（group B, 45 cases）. The patients were followed-up for 12 months. Clinical outcomes were assessed using VAS pain score and Oswestry disability index（ODD. By X-ray measurements, the restoration rate of vertebral body height and correction rate of kyphotic angle were calculated. The cement leakage and new adjacent vertebral fractures were observed. Results Compared to before, the VAS pain score and ODI were significantly improved after operation（P〈0. 05）. The heights of anterior, middle and posterior vertebral body in 12 months in group B after operation were increased by 19.3% ,23. 9% and 7. 9%, respectively,which were significantly more than 13.7%, 11.0% and 3.8% in group A（P〈0. 05）. The decrease of kyphotic angle was more in group B than that in group A（P〈0. 05）. The cement leakage rate was higher in group A than that in group B（34. 6% vs. 9.1%） （P〈0. 05）. The incidence of new adjacent vertebral fractures in both groups was similar（P〉0. 05）. Conclusion Both of PKP and PVP can effectively attenuate pain and improve the quality of life. Compared to PVP, PKP is better in the restoration of vertebral body heizht and correction of kvohotic deformitv.