经皮椎体后凸成形术和椎体成形术治疗骨质疏松性椎体压缩性骨折的疗效和安全性评价

Efficacy and Safety of Percutaneous Kyphoplasty and Vertebroplasty in the Treatment of Osteoporotic Vertebral Compression Fractures

目的对比研究经皮椎体后凸成形术(PKP)和椎体成形术(PVP)治疗骨质疏松性椎体压缩性骨折的疗效及手术的安全性。方法随机选取2015年1月—2017年12月在该院接受手术治疗的骨质疏松性椎体压缩性骨折患者(98例)作为研究对象,并采用随机分组法将其分为研究组和对照组,其中给予研究组患者经皮椎体后凸成形术,给予对照组患者经皮椎体成形术治疗,对比分析两组临床疗效及其安全性。结果术后研究组患者治疗总有效率稍高于对照组患者,差异无统计学意义(P>0.05);研究组并发症发生率为4.0%,明显低于对照组27.1%,差异有统计学意义(χ^2=10.964,P<0.05)。研究组患者术后6个月VAS评分为(2.8±0.7)分、术后12个月VAS评分为(1.5±0.7)分低于对照组患者的(4.6±1.3)分与(3.1±1.1)分,差异有统计学意义(t=11.854、16.481,P<0.05)。研究组患者术后6个月ODI评分为(26.3±3.2)分、12个月ODI评分为(19.8±2.8)分低于对照组患者的(33.6±3.3)分与(26.8±3.0)分,差异有统计学意义(t=5.854、10.481,P<0.05)。结论经皮后凸成形术和椎体成形术均能显著改善骨质疏松性椎体压缩性骨折患者的病痛。但在远期疗效、术后功能恢复及手术并发症、安全性等诸方面,前者显著优于后者,建议优先推广使用经皮椎体后凸成形术。

Objective To compare the efficacy and surgical safety of percutaneous kyphoplasty(PKP)and vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fractures.Methods Patients with osteoporotic vertebral compression fractures(98 cases)who underwent surgery in our hospital from January 2015 to December 2017 were randomly selected as subjects.They were randomly divided into study group and In the control group,the patients in the study group were treated with percutaneous kyphoplasty and the patients in the control group were treated with percutaneous vertebroplasty.The clinical efficacy and safety of the two groups were compared.Results The total effective rate of the postoperative study group was slightly higher than that of the control group,and the difference was not statistically significant(P>0.05).The complication rate of the study group was 4.0%,which was significantly lower than that of the control group 27.1%(χ^2=10.964,P<0.05).The VAS score of the study group was(2.8±0.7)points at 6 months postoperatively,and the VAS score was(1.5±0.7)points;at 12 months postoperatively(4.6±1.3)points and(3.1±1.1)points,the difference was statistically significant(t=11.854,16.481,P<0.05).In the study group,the ODI score was(26.3±3.2)points at 6 months after operation,and the ODI score at 12 months(19.8±2.8)points was lower than(33.6±3.3)points and(26.8±3.0)points in the control group,the difference was statistically significant(t=5.854,10.481,P<0.05).Conclusion Percutaneous kyphoplasty and vertebroplasty can significantly improve the pain of patients with osteoporotic vertebral compression fractures.However,in the long-term efficacy,postoperative functional recovery and surgical complications,safety and other aspects,the former is significantly better than the latter,it is recommended to preferentially promote the use of percutaneous kyphoplasty.