单、双侧经椎弓根途径PKP术治疗骨质疏松性胸椎压缩性骨折的临床疗效对比

Comparison of the Clinical Effects of Unilateral Versus Bilateral PKP for Treating Osteoporotic Vertebral Compression Fractures

目的:比较经单侧与双侧椎弓根途径行经皮穿刺球囊扩张椎体后凸成形术(PKP术)治疗骨质疏松性胸椎压缩性骨折的临床效果。方法:本院骨科2013年1月至2017年1月因骨质疏松性胸椎压缩骨折行PKP手术治疗的160例患者纳入研究,根据手术穿刺通道不同分为单侧组与双侧组,比较两组患者手术一般情况、手术前后的Oswestry功能障碍指数(ODI)、伤椎体高度变化。结果:两组患者术后的ODI指数、伤椎体高度相比手术前均显著改善,差异有统计学意义(P<0.01),单侧组与双侧组之间无明显差异,差异无统计学意义(P>0.05),但单侧组手术时间、术中骨水泥使用量及透视次数明显低于双侧组,差异有统计学意义(P<0.05)。结论:经单侧或双侧椎弓根途径行PKP术治疗骨质疏松性胸椎压缩性骨折临床效果相似,但经单侧椎弓根途径的PKP手术时间短、放射暴露少、骨水泥用量少,且术后发生骨水泥渗漏的概率更小。

Objective：To compare the clinical efficacy of unilateral and bilateral balloon percutaneous kyphoplasty（PKP）in the treatment of osteoporotic vertebral compression fractures（OVCF）.Methods：All 80 patients with OVCF,were operated with PKP in the department of orthopedics in our hospital from January 2013 to January 2017,who were divided into unilateral group and bilateral group according to the different ways of surgical choice.The inclusion criteria,ODI index,the changes of vertebral height of two groups before and after operation were compared.Results：The postoperative ODI index and vertebral height of two groups were significantly improved than that before（P〈0.01）.Nevertheless,there was no significant difference between unilateral and bilateral groups（P〉0.05）.But the operative time,bone cement usage and the number of fluoroscopy of unilateral group was significantly less than that of bilateral group（P〈0.05）.Conclusion：Both unilateral and bilateral PKP is similarly clinical effective for treating OVCF.The unilateral PKP is with the advantages of small wounds,shorter operation time,smaller radiation,less bone cement,and lower risk of bone cement leakage.