两种术式治疗老年骨质疏松性椎体压缩性骨折的疗效比较

Comparison of efficacy of two methods in treatment of osteoporotic vertebral compression fracture in the elderly patients

目的探讨椎体成形术(PVP)和椎体后凸成形术(PKP)治疗老年骨质疏松性椎体压缩性骨折(OVCF)的临床疗效。方法将112例OVCF患者根据入院先后顺序分成PVP单侧穿刺组(32例)、PVP双侧穿刺组(28例)、PKP单侧穿刺组(27例)、PKP双侧穿刺组(25例)。比较4组间手术时间、骨水泥渗漏率、椎体前缘高度比、住院天数、手术前后疼痛VAS评分。结果112例患者均获得随访,时间6~13个月。手术时间:PVP单侧穿刺组与双侧穿刺组比较差异无统计学意义(P>0.05),PKP单侧穿刺组与双侧穿刺组比较差异有统计学意义(P<0.01),且PVP两组与PKP两组间比较差异均有统计学意义(P<0.01)。骨水泥渗漏率、椎体前缘高度比:PVP两组间比较差异无统计学意义(P>0.05),PKP两组间比较差异无统计学意义(P>0.05),但PVP两组与PKP两组间比较差异有统计学意义(P<0.01)。住院天数、手术前后VAS评分4组间比较差异均无统计学意义(P>0.05)。结论OVCF采用PVP与PKP治疗疗效均满意。PVP手术时间短、费用低,但骨水泥渗漏率偏高,不能恢复压缩椎体高度;PKP骨水泥渗漏率低,利于恢复压缩椎体高度,但手术时间长、费用高。

Objective To investigate the clinical effects of percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in treatment of osteoporotic vertebral compression fracture(OVCF)in the elderly patients.Methods According to the order of admission,the 112 OVCF patients were divided into PVP unilateral puncture group(32 cases),PVP bilateral puncture group(28 cases),PKP unilateral puncture group(27 cases)and PKP bilateral puncture group(25 cases).The operation time,bone cement leakage rate,the rate of vertebral anterior margin height,length of hospital stay,and VAS before and after surgery were compared among the four groups.Results All 112 cases were followed up for 6~13 months.Operation time:there was no statistical significance between PVP unilateral puncture group and bilateral puncture group(P>0.05),and the difference was statistically significant between PKP unilateral puncture group and bilateral puncture group(P<0.01),and the differences between PVP two groups and PKP two groups were statistically significant(P<0.01).Bone cement leakage rate and the vertebral anterior edge height rate:there was no statistical significance between the two groups of PVP(P>0.05)and PKP(P>0.05),while the differences between the two groups of PVP and PKP were statistically significant(P<0.01).There were no significant differences among the four groups in length of hospital stay and VAS before and after surgery(P>0.05).Conclusions Both PVP and PKP are effective in the treatment of OVCF.PVP has short operation time and low cost,but the rate of bone cement leakage is high,and the height of the compressed vertebral body cannot be restored.Bone cement leakage rate of PKP is low,which is beneficial to restore the height of the compressed vertebrae,but the operation time is long and the cost is high.