行单侧PKP治疗骨质疏松性椎体压缩骨折术后对侧椎体骨密度的变化分析

Analyze the changes of the contralateral vertebral bone mineral density after unilateral PKP treatment for osteoporotic vertebral compression fractures

目的探讨单侧PKP手术治疗骨质疏松性椎体压缩骨折后,其对侧椎体骨密度的变化情况。方法将2014-05-2016-01收治的42例OVCF患者纳入本研究,均采用左侧椎弓根穿刺PKP手术治疗,分别于手术前后测量其右侧半椎体的骨密度变化情况,并进行对比。结果所有患者均随访1年以上,患者VAS评分、ODI指数均有显著下降(P<0.05),且伤椎高度和后凸Cobb角均有显著的矫正效果(P<0.05);随访期间,仅2例出现对侧椎体塌陷现象,发生率为4.8%。其右侧半椎体的骨密度值术前平均为(0.671±0.058)g/cm^2,术后含骨水泥假体的骨密度值为(1.108±0.193)g/cm^2,其差值为(0.437±0.062)g/cm^2,差异有统计学意义(t=14.053;P<0.05);通过软件测量的术后去骨水泥假体骨密度值为(0.782±0.061)g/cm^2,与术前相比的差值为(0.111±0.053)g/cm^2,差异亦有统计学意义(t=8.546;P<0.05),较术前提高了16.5%。结论单侧PKP手术治疗OVCF患者的疗效可靠,术后对侧椎体骨密度亦有明显提高,对侧椎体再塌陷的风险低。

Objective To investigate the changes of the contralateral vertebral bone mineraldensity after unilateral PKP surgery for osteoporotic vertebral compression fractures. Methods 42 cas-es of OVCF patients in May 2014-2016 year in January were included in this study, using the leftpedicle puncture PKP surgical treatment, the changes of bone mineral density were measured beforeand after surgery in the right half of the vertebral body, and compared. Results all patients were fol-lowed up for more than 1 years, patients with VAS score and ODI index were significantly decreased（P〈0.05）, significant effect and correction of vertebral height and kyphosis angle were Cobb （P〈0.05）;during follow-up, only 2 cases of contralateral vertebral collapse, the incidence rate was 4.8%. Theright half vertebral bone density value of the preoperative average （0.671±0.058） g/cm^2 bone density,bone cement prosthesis with postoperative value （1.108±0.193） g/cm^2, the difference is （0.437±0.062）g/cm^2, the difference was statistically significant （t=14.053; P〈0.05）; through the software measurementafter operation to bone cement prosthesis bone density is（0.782±0.061） g/cm^2, the difference was com-pared with the preoperative （0.111±0.053） g/cm^2, there was also significant difference（ t=8.546;P〈0.05）, increased by 16.5% compared with the preoperative. Conclusion the unilateral PKP operationis reliable for the treatment of OVCF patients, and the BMD of the contralateral vertebral body is obvi-ously improved.