单侧及双侧PVP治疗骨质疏松性胸腰椎压缩骨折临床效果比较

Comparison of Clinical Effect of Unilateral and Bilateral PVP in Treatment of Osteoporotic Thoracolumbar Compression Fracture

目的分析对骨质疏松性胸腰椎压缩性骨折患者采用单侧或双侧经皮椎体成形术的治疗价值。方法选取2017年9月至2019年5月甘肃省金昌市中西医结合医院收治的74例骨质疏松性胸腰椎压缩性骨折手术患者,依据皮椎体成形术(PVP)手术入路分为2组,各37例。观察组采取单侧PVP手术,对照组为双侧PVP手术。比较2组手术指标以及术后视觉模拟评分法(VAS)评分、Cobb角、伤椎椎体的前缘高度。结果2组患者的骨水泥渗漏发生率比较差异无统计学意义(P>0.05);观察组的手术时间、术中骨水泥注入量及术中X线透视次数少于对照组(P<0.05);2组患者术后随访3个月和6个月时VAS疼痛评分、Cobb角以及伤椎椎体的前缘高度比较差异无统计学意义(P>0.05);2组患者手术后3 d的腰椎Oswestry功能障碍指数(ODI)评分较手术前下降,组间比较差异无统计学意义(P>0.05);观察组手术后3个月、6个月时ODI评分显著低于同期对照组(P<0.05)。结论在骨质疏松性胸腰椎压缩性骨折患者治疗中采用单侧或双侧PVP手术治疗均可取得较为理想的手术效果,然而单侧PVP手术有利于缩短手术时间并减少骨水泥的注入量和术中X线透视频次。

Objective To analyze the therapeutic value of unilateral or bilateral percutaneous vertebroplasty in patients with osteoporotic thoracolumbar compression fractures.Methods From September 2017 to May 2019,74 cases of osteoporotic thoracolumbar compression fracture were selected from Jinchang Hospital of traditional Chinese and Western medicine.According to the PVP approach,they were divided into two groups,37 cases in each group.The observation group received unilateral PVP operation and the control group received bilateral PVP operation.The general operative indexes,VAS score,Cobb angle and anterior height of injured vertebrae were compared between the two groups.Results There was no significant difference between the two groups(P>0.05).The time of operation,the amount of bone cement and the times of X-ray fluoroscopy in the observation group were less than those in the control group(P<0.05).There was no significant difference in VAS pain score,Cobb angle and anterior edge height of injured vertebra between the two groups(P>0.05).The ODI scores of the two groups were lower than that of the two groups before operation,and there was no significant difference between the two groups(P>0.05).The decrease of ODI in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Unilateral or bilateral PVP surgery in the treatment of patients with osteoporotic thoracolumbral compression fracture can achieve relatively ideal results,while unilateral PVP surgery is beneficial to shorten the operation time and reduce the amount of bone cement injection and intraoperative X-ray frequency.