骨填充网袋与球囊椎体后凸成形修复骨质疏松性椎体压缩性骨折

Bone filling mesh container versus balloon percutaneous kyphoplasty repairs osteoporotic vertebral compressive fracture

背景:目前国内外的学者对骨填充网袋与球囊椎体后凸成形临床特点研究资料较少,在缓解疼痛、纠正后凸畸形和恢复椎体高度等方面的疗效以及骨水泥渗漏的发生率方面存在较大的争议。目的:比较骨填充网袋与球囊椎体后凸成形治疗骨质疏松性椎体压缩性骨折的临床特点。方法:将90例骨质疏松性椎体压缩性骨折患者随机分成2组:椎体后凸成形组45例,采用球囊椎体成形治疗;骨填充网袋组45例,采用骨填充网袋治疗。术后随访时间均大于3个月,观察两组之间在缓解疼痛、纠正后凸畸形及恢复椎体高度等方面的疗效,以及骨水泥渗漏的发生率。结果与结论:(1)缓解疼痛、纠正后凸畸形及恢复椎体高度:所有患者术后24 h内疼痛均明显缓解,两组在缓解疼痛方面效果相似(P>0.05),在恢复椎体高度方面椎体后凸成形优于骨填充网袋(P<0.05);在骨水泥渗漏方面骨填充网袋组优于椎体后凸成形组(P<0.05)。(2)结果说明:骨填充网袋与球囊椎体后凸成形治疗骨质疏松性椎体压缩性骨折各有优势,但镇痛效果相似。

BACKGROUND：It remains controversial about the clinical outcomes of bone fil ing mesh containers （BFMCs） and percutaneous kyphoplasty （PKP） in pain relief, kyphosis correction, vertebral height restoration and reduction of cement leakage. OBJECTIVE：To compare the clinical outcomes of BFMCs and PKP for osteoporotic vertebral compressive fracture. METHODS：A total of 90 patients with osteoporotic vertebral compressive fracture were equivalently randomized into two groups, fol owed by treated with BFMCs or PKP, respectively. During a more than 3-month fol ow-up, pain relief, kyphotic angle, the vertebral height and cement leakage were observed in the two groups to assess the therapeutic effects. RESULTS AND CONCLUSION：Pain in al patients was relieved at 24 hours after operation. There was no significant difference in pain relief between two groups （P〉0.05）. PKP was more effective to restore the vertebral height （P〈0.05）, while BMCFs significantly reduced the leakage rate of bone cement （P〈0.05）. These results suggest that BFMCs and PKP have their own advantages in the treatment of osteoporotic vertebral compressive fracture, but both exert analgesic effects.