椎体成形术与椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的效果比较

Comparison of the clinical effects of percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures

目的 探讨椎体成形术（PVP）与椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩性骨折的有效性和安全性,为临床治疗提供参考依据.方法 选择67例骨质疏松性椎体压缩性骨折患者为研究对象,根据不同术式分为PVP组（n=32）和PKP组（n=35）,比较两组患者的手术情况、疼痛程度、椎体相对高度、Cobb角以及骨水泥渗漏发生率.结果 PKP组手术时间、透视次数、骨水泥注入量、术后伤椎高度均明显优于PVP组,骨水泥渗漏率明显低于PVP组（均P〈0.05）;术后12个月,PKP组椎体压缩率低于PVP组（P〈0.05）,两组患者VAS评分、Cobb角差异无统计学意义（P〉0.05）.结论 PVP与PKP均是治疗骨质疏松性椎体压缩性骨折的有效术式,PKP更有利于促进患者椎体高度恢复,且减少了骨水泥渗漏的发生.

Objective To investigate the effect and safety of percutaneous vertebroplasty （PVP） and percutaneous kyphoplasty （PKP） in the treatment of osteoporotic vertebral compression fractures, thus to provide reference for clinical treatment. Methods 67 patients with osteoporotic vertebral compression fractures were selected as study subjects. According to the different operation type, the patients were divided into PVP group （ n = 32 ） and PKP group（ n = 35 ）. The operation condition ,pain degree,relative height of vertebral body, Cobb angle and incidence of cement leakage were compared between the two groups. Results The operation time, X - ray times, bone cement injection volume, postoperative injury vertebral height of the PKP group were significantly higher than those of the PVP group （all P 〈 0. 05 ）, the bone cement leakage rate of the PKP group was significantly lower than that of PVP group （P 〈 0.05）. 12 months after operation, the vertebral compression rate of the PKP group was lower than that of PVP group（P 〈0.05 ）, there were no statistically significant differences in VAS scores and Cobb angle between the two groups （ all P 〉 0.05 ）. Conclusion PVP and PKP are the effective methods for the treatment of osteoporotic vertebral compression fractures, which can significantly improve the degree of pain in patients, but PKP surgery is more conducive to promote the restoration of vertebral height, and can reduce the occurrence of bone cement leakage.