微创脊柱外科应用经皮椎体成形术和后凸成形术的临床疗效观察

Observation on clinical efficacy of percutaneous vertebroplasty and kyphoplasty in minimally invasive spinal surgery

目的研究微创脊柱外科应用经皮椎体成形术和后凸成形术的临床疗效。方法 68例压缩性骨折患者,根据随机数字表法分为对照组和观察组,每组34例。对照组患者应用后凸成形术治疗,观察组患者应用经皮椎体成形术治疗。比较两组患者手术前后伤椎高度、椎体疼痛、Cobb角情况和临床效果、骨水泥渗漏率、手术费用。结果两组总有效率比较差异无统计学意义(P>0.05)。观察组骨水泥渗漏率为23.53%(8/34),高于对照组的2.94%(1/34),差异具有统计学意义(P<0.05);观察组手术费用为(4.14±1.15)千元,明显低于对照组的(6.24±1.91)千元,差异具有统计学意义(P<0.05)。两组患者手术后伤椎高度、椎体疼痛、Cobb角均较手术前改善,且对照组伤椎高度优于观察组,差异具有统计学意义(P<0.05)。结论微创脊柱外科应用经皮椎体成形术和后凸成形术的临床疗效相似,均可缓解疼痛,恢复伤椎高度,但经皮椎体成形术更容易出现骨水泥渗漏,费用更低,后凸成形术可更好恢复伤椎高度,可根据患者情况选择合适的手术。

Objective To study the clinical efficacy of percutaneous vertebroplasty and kyphoplasty in minimally invasive spinal surgery. Methods A total of 68 patients with compression fracture were divided by random number table method into control group and observation group, with 34 cases in each group. The control group was treated with kyphoplasty, and the observation group was treated with percutaneous vertebroplasty. Comparison were made on traumatic vertebrae height, vertebral pain, Cobb angle condition before and after operation and clinical effect, bone cement leakage rate, surgical costs between the two groups. Results Both groups had no statistically significant difference in total effective rate（P〈0.05）. The observation group had higher bone cement leakage rate as 23.53%（8/34） than 2.94%（1/34） in the control group, and the difference was statistically significant（P〈0.05）. The observation group had obviously lower surgical costs as（4.14±1.15） thousand yuan than（6.24±1.91） thousand yuan in the control group, and the difference was statistically significant（P〈0.05）. Both groups had improved traumatic vertebrae height, vertebral pain and Cobb angle after operation than before operation, and the control group had better vertebral height than the observation group. Their difference was statistically significant（P〈0.05）. Conclusion Application of percutaneous vertebroplasty and kyphoplasty shows similar clinical efficacy in minimally invasive spinal surgery, and both can relieve pain, restore vertebral height. However, percutaneous vertebroplasty is more prone to bone cement leakage with lower cost and better kyphoplasty, and it can better restore the vertebral height. Appropriate operation should be chosen according to the conditions of patients.