椎体成形术与椎体后凸成形术治疗骨质疏松性椎体压缩骨折术后伤椎再塌陷的对比研究

Recollapses of previous augmented osteoporotic compressed vertabrae: comparative analysis of percutaneous vertebroplasty and percutaneous kyphoplasty

目的观察椎体成形术（percutaneous vertebroplasty,PVP）和椎体后凸成形术（percutaneous kyphoplasty,PKP）治疗骨质疏松性椎体压缩骨折（osteoporosis vertebral compression fracture,OVCF）术后发生伤椎再塌陷情况的差异。方法回顾性分析2007年1月~2012年1月本院采用此2种术式治疗,并获完整随访的OVCF患者资料581例。依据术式分组并测量术前、术后3 d内及末次随访的伤椎高度,对比伤椎再塌陷发生率及再塌陷所造成的矫正高度丢失比的组间差异,并结合既往研究及影像观察分析差异原因。结果术后伤椎再塌陷发生率PVP组为2.94%,PKP组为16.19%;再塌陷所造成矫正高度丢失比PKP组为〉PVP组。结论 PVP、PKP治疗OVCF,术后伤椎再塌陷风险不同,PKP较PVP更严重,此现象需引起重视,值得进一步研究。

Objective To compare the difference of recollapse between percutaneous vertebroplasty（ PVP） and percutaneous kyphoplasty（ PKP） for osteoporotic vertebral compression fractures（ OVCF）. Methods From January 2007 to January 2012,581 cases who underwent PVP or PKP for OVCF retrospectively with detailed radiological follow-up were reviewed. Vertebral heights were measured at 3 different time points： preoperatively,postoperatively（ whith in 3 d） and final follow-up. The occurrence of recollapse rate and the ratio of vertebral height loss（ recollapsed vertebral heights / restoration of vertebral heights right after operation） in recollapsed vertebrae were recorded in each group. Results The recollapse ratio in PVP group was 2. 94%,while the number was 16. 19% in PKP group. The loss ratio of vertebral heights in PKP group was also higher than those in PVP group. Conclusion Compared with PKP,PVP is more capable of keeping vertebral heights,and it should be taken seriously.