老年椎体骨质疏松压缩性骨折椎体成形手术策略及疗效评估研究

Outcome analysis of percutaneous vertebroplasty and percutaneous kyploplasty for osteoporotic vertebral compression fracture

目的分析椎体成形手术策略选择(经皮椎体成形术PVP与椎体后凸成形术PKP)治疗老年骨质疏松性椎体压缩骨折(OVCF)的临床疗效和安全性。方法对自2009-09—2012-09行PVP治疗的38例(45个椎体)与PKP治疗的42例(45个椎体)骨质疏松椎体压缩骨折的治疗情况进行回顾性分析。结果 2组椎体前缘高度保持度PKP组具有明显优势(P<0.001),各组术后较术前的临床疗效,差异有统计学意义(P<0.001),但2组之间的临床疗效差异无统计学意义(P>0.05)。PVP组骨水泥渗漏率显著低于PKP组,差异有统计学意义(P<0.05)。结论对于老年骨质疏松性椎体压缩骨折的椎体成形术手术策略选择上,需按照个体的具体情况进行分析,总体上说PVP组在安全性上要优于PKP组,PVP可作为治疗骨质疏松的首选方法 。

Objective To study the feasibility of pereutaneous vertebroplasty and percutaneous kyploplasty in the treatment of osteoporotie vertebral compression fracture and evaluate the result. Methods Eighty patients with osteoporotic vertebral compression fracture from Sept. 2009 to Sept. 2012 were included in this clinical study. Thirty eight cases underwent pereutaneous vertebroplasty （45 vertebral bodies） and 42 cases received pereutaneous kyploplasty （45 vertebral bodies）. Results The anterior flange height degree of PKP group was better than the PVP group （P 〈0.001）. And the clinical curative effect was significantly improved than the preoperative （P 〈0.001）. But there was no significant statistical difference between the two groups （P 〉0.05）. The bone cement leakage rate of PVP group was lower than the PKP group （P 〈0.05）. Conclusion How to choose the best way of treatment for osteoporotie vertebral compression fracture must be based on special individual circumstances. And PVP is safer than the PKP in treatment of osteoporotic verteral compression fracture.