单侧与双侧经皮后凸成形术治疗高龄骨质疏松性椎体压缩性骨折的疗效对比

The clinical effect of unilateral and bilateral percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures

目的探讨单侧与双侧经皮椎体后凸成形术(PKP)治疗高龄性(大于80岁)骨质疏松性椎体压缩性骨折的临床疗效。方法选择该院2015年1月至2018年1月收治的116例高龄性(年龄大于80岁)骨质疏松性椎体压缩性骨折(OVCF)患者,随机分为2组,每组58例,其中单侧组予以单侧PKP治疗,双侧组予以双侧PKP治疗。观察并比较两组手术时间、侧凸Cobb角、椎体前缘高度、疼痛视觉模拟评分(VAS)、骨水泥渗漏及术后并发症情况。结果单侧组手术时间及透视次数明显低于双侧组,差异有统计学意义(P<0.05);两组术后VAS、侧凸Cobb角、椎体高度与术前比较,差异均有统计学意义(P<0.05),但2组组间比较,差异无统计学意义(P>0.05)。单侧组骨水泥渗漏率8.3%,双侧组为9.4%,两组比较,差异无统计学意义(P>0.05)。结论单侧PKP与双侧PKP均能缓解高龄OVCF患者疼痛症状,具有相同的手术效果;但是单侧PKP具有创伤小、手术时间短、术中透视次数少及风险小等优点,更适合高龄OVCF患者。

Objective To investigate the clinical effect of unilateral and bilateral percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures in the elderly (>80 years old). Methods From January 2015 to January 2018,116 patients with osteoporotic vertebral compression fracture were randomly divided into two groups,58 cases in each group.One side group was treated with unilateral PKP.Bilateral group was treated with bilateral PKP.The operative time,Cobb angle of scoliosis,height of vertebral body,VAS,leakage of bone cement and postoperative complications were observed and compared between the two groups. Results The operation time and radiation time in unilateral group were significantly less than those in bilateral group ( P <0.05),the postoperative VAS,Cobb angle of scoliosis and vertebral height in two groups were significantly less than those in the preoperation ( P <0.05),but there was no significant difference between the two groups ( P >0.05).The leakage rate of bone cement was 8.3% in unilateral group and 9.4% in bilateral group.There was no significant difference between the two groups ( P >0.05). Conclusion Both unilateral PKP and bilateral PKP can relieve pain symptoms in elderly patients with OVCF and have the same surgical effect,but unilateral PKP has the advantages of less trauma,shorter operation time,less radiation and less risk,so it is more suitable for the elderly patients with OVCF.