单、双侧椎弓根穿刺行PKP治疗效果比较

The comparison of clinical outcomes between unipedicular and bipedicular puncture in PKP operations

目的比较经单双侧椎弓根穿刺行PKP治疗椎体骨质疏松性压缩性骨折(OVCFs)的临床效果。方法 2010-01-2013-08期间,我院行PKP治疗OVCFs患者91例(91椎),其中双侧椎弓根穿刺59例(59椎),单侧穿刺32例(32椎)。比较两组术前、出院时和术后12个月随访结果。结果术前两组患者各项指标无明显差异。两组术后的VAS评分改善率无明显差异;Cobb角改善率和椎体前缘高度改善率方面,双侧组较单侧组高,单侧组手术出血量少于双侧组,差异均具有统计学意义(P<0.05);单侧组手术时间少于双侧组(P<0.05)。两组均未出现有症状的骨水泥渗漏者。单侧组出现4例有症状的伤椎再骨折,而双侧组有1例。结论单、双侧PKP均能有效缓解OVCFs的疼痛;经双侧椎弓根穿刺较单侧穿刺能更好的恢复伤椎形态,维持伤椎稳定性,伤椎再骨折的发生率较低。

Objective To analyze the different clinical effect between single pedicular and double pedicular PKP in the treatment of vertebral osteoporosis compression fractures （OVCFs）. Methods From January 2010 to August 2013, 91 patients （91 vertebral bodies）who suffered from OVCFs disease took PKP operation in our hospital were selected, 59 patients accepted PKP operation through bilateral pedicle puncture and 32 patients through unilateral pediele puncture. The outcomes of two groups before,after operation and at 12 months follow-up were compared. Results There was no significant difference in VAS score, but operation time of the unilateral puncture group was less than bilateral puncture group （P〈0.05）. In the two groups , there were no symptomatic bone cement leakages. In unilateral puncture group, there were 4 vertebral refracture with symptoms, while there was 1 case in bilateral puncture group. Conclusion PKP is an effective method for OVCFs. Compared with unilateral pedicle puncture operation, bilateral pedicle puncture operation gets better recovery of injured vertebral shape,more stabilized vertebrae and the incidence of vertebral refracture with clinical symptoms is lower.