两种术式治疗骨质疏松压缩骨折的疗效比较

The efficacy comparison of two surgery methods in the treatment of osteoporotic vertebral compression fractures

目的 探讨经皮椎体后凸成形术(PKP)与经皮椎体成形术(PVP)治疗骨质疏松压缩骨折的有效性及安全性。方法 将150例骨质疏松压缩骨折患者随机分为PVP组(采用PVP治疗)和PKP组(采用PKP治疗),每组75例。比较两组患者疗效及畸形矫正情况。结果 患者均获得15个月随访。手术时间及骨水泥渗漏个数PKP组短(少)于PVP组(P<0.05),骨水泥注入量及术后伤椎高度增加PKP组多于PVP组(P<0.05)。术后3 d,伤椎椎体前、中部高度PKP组均高于PVP组(P<0.05)。术后6个月、1年,VAS评分、伤椎Cobb角水平两组均较术前降低(P<0.05),PKP组均低于PVP组(P<0.05)。结论 采用PKP与PVP治疗骨质疏松压缩骨折患者均能获得较好的疗效,促进患者康复,但PKP疗效优于PVP。

Objective To investigate the effectiveness and safety of percutaneous kyphoplasty(PKP) and percutaneous vertebroplasty(PVP) in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods The 150 patients with OVCF were randomly divided into PVP group(PVP treatment)and PKP group (PKP treatment),with 75 cases in each group.The therapeutic effect and deformity correction situation of the two groups were compared.Results All cases were received 15 months of follow-up.The operation time and number of bone cement leakage in the PKP group were shorter(less) than those in the PVP group(P<0.05),while the PKP group with bone cement injection volume and postoperative injuried vertebrae increased height were higher than those in the PVP group(P<0.05). At postoperative 3 d,the anterior and middle height of the injured vertebrae in the PKP group were significantly higher than those in the PVP group (P<0.05). At 6 months and 1 year after operation,the VAS and the Cobb angle of the injured vertebrae of the two groups were significantly decreased than those before operation;and the data of the PKP group were lower than those in the PVP group(P<0.05).Conclusions Both PKP and PVP have better therapeutic effect on patients with OVCF and promote rehabilitation,while the effect of PKP is significantly superior to PVP.