Jack椎体扩张器后凸成形术与球囊扩张后凸成形术对骨质疏松性椎体压缩骨折的疗效比较

Efficacy comparison between Jack dilator kyphoplasty and balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures

目的:比较Jack椎体扩张器后凸成形术(DKP)与球囊扩张后凸成形术(BKP)治疗骨质疏松性椎体压缩骨折的临床疗效。方法:收集骨质疏松性椎体压缩骨折病人52例,按照治疗方法分为DKP组25例和BKP组27例,比较2组手术效果。结果:2组手术时间、术中出血量和骨水泥注入量差异均无统计学意义(P>0.05)。2组术后及末次随访时椎体前缘、中部高度均较治疗前提高(P<0.05),后凸角(Cobb角)均较术前降低(P<0.05~P<0.01);末次随访时DKP组椎体前缘高度高于BKP组,Cobb角低于BKP组(P<0.05)。2组病人术后、末次随访时的疼痛视觉模拟评分和Oswestry功能障碍指数评分均较术前下降(P<0.05~P<0.01),而2组间差异均无统计学意义(P>0.05)。DKP组骨水泥渗漏率低于BKP组(P<0.05)。结论:DKP和BKP应用于骨质疏松性椎体压缩骨折病人疗效相近,DKP在矫正后凸Cobb角和恢复椎体前缘高度方面优于BKP。

Objective： To compare the clinical effects between Jack dilator kyphoplasty（ DKP） and balloon kyphoplasty（ BKP） in the treatment of osteoporotic vertebral compression fractures. Methods： Fifty-two patients with osteoporotic vertebral compression fractures were divided into the DKP group（ 25 cases） and BKP group（ 27 cases） according to the treatment method. The operation effect between two groups was compared. Results： The differences of the operation time,peroperative bleeding and bone cement injection volume between two groups were not statistically significant（ P 〉0. 05）. Compared with before treatment,the height of fanterior edge and middle part in two groups increased after operation and at last follow-up,and the Cobb angle in two groups after operation decreased compared with before operation（ P〈 0. 05 to P 〈0. 01）. The height of fanterior edge and Cobb angle in DKP group at last follow-up were higher and lower than that in BKP group,respectively（ P 〈0. 05）. Compared with before operation,the scores of VAS and ODI in two groups decreased after operation and at last follow-up（ P 〈0. 05 to P 〈0. 01）,and the difference of which between two groups was not statistically significant（ P 〉0. 05）. The bone cement leakage rate in DKP group was lower than that in BKP group（ P 0. 05）.Conclusions： The effects of DKP and BKP in the treatment of osteoporotic vertebral compression fractures are similar,and the effect of DKP on the recovery of the convex Cobb angle and anterior height of the vertebral body is better than that of the BKP.