PVP与PKP治疗骨质疏松性胸腰椎Ⅰ度压缩骨折的临床疗效观察

Clinical Efficacy of PVP and PKP for Treating Osteoporotic Thoracolumbar Compression Fractures of DegreeⅠ

目的:比较PVP与PKP治疗骨质疏松性胸腰椎Ⅰ度压缩骨折的临床疗效及并发症。方法:回顾性分析63例骨质疏松性胸腰椎Ⅰ度压缩骨折患者的临床资料,根据手术方法不同,将其分为PVP组(30例)和PKP组(33例)。观察并比较两组患者术后骨水泥在骨折线内的弥散情况、病椎高度丢失率及Cobb角变化情况以及手术前后Oswestry功能障碍指数(ODI)及VAS评分。结果:术后复查见PVP组骨水泥弥散效果较PKP组好,术后随访发现PVP组病椎高度丢失率及Cobb角明显小于PKP组(P<0.05)。两组组内术后ODI及VAS评分较治疗前明显改善(P<0.05)。术后1 dPVP组ODI及VAS评分低于PKP组(P<0.05),但术后1,6,12个月随访两组ODI及VAS评分比较差异无统计学意义(P>0.05)。结论:PVP治疗骨质疏松性胸腰椎Ⅰ度压缩骨折,其骨水泥弥散效果优于使用PKP,早期能快速缓解疼痛,改善功能障碍,并减少远期发生椎体高度丢失的可能性。

Objective：To compare the therapeutic efficacy and complications of PVP and PKP for treating osteoporotic thoracolumbar vertebral compression fractures of I degree.Methods：Retrospective analyzed the clinical data of 63 cases with osteoporotic thoracolumbar compression fractures of I degree in our department.They were divided into PVP group（n=30）and PKP group（n=33）depending on the treatment method.The loss rate of vertebral height,the changes of Cobb angle,the preoperative and postoperative Oswestry disability index（ODI）,and VAS score were observed and compared after bone cement dispersion within the fracture line.Results：The cement dispersion effect of PVP group was better than that of PKP group after review.The vertebral height and Cobb angle loss rate of PVP group was significantly less than PKP group（P〈0.05）.The ODI and VAS score of two groups were significantly improved after treatment（P〈0.05）.The ODI and VAS score of PVP group were lower than PKP group at 1st day after operation（P〈0.05）,but there were not statistically significant at 1st,6th,and 12th months after operation.Conclusion：PVP is effective for treating osteoporotic thoracolumbar vertebral compression fractures of I degree,which is superiority than PKP,with advantages of relieving pain quickly,improving dysfunction,and reducing the likelihood of long-term occurrence of vertebral height loss.