3种术式治疗骨质疏松性椎体压缩骨折的疗效与骨水泥分布

Efficacy and bone cement distribution of three surgical methods for osteoporotic vertebral compression fractures

目的比较弯角椎体成形术(PCVP)与单、双侧椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折(OVCF)的疗效和骨水泥分布。方法将90例OVCF患者随机分成PCVP组、单侧PVP组和双侧PVP组,每组30例。比较3组手术数据、骨水泥渗漏率、骨水泥理想分布椎体比例以及治疗前后疼痛VAS评分。结果患者均获得1个月随访。骨水泥注入量、手术时间PCVP组和单侧PVP组均少(短)于双侧PVP组(P<0.05),Cobb角恢复率3组间比较差异无统计学意义(P>0.05)。骨水泥理想分布椎体比例PCVP组和双侧PVP组高于单侧PVP组(P<0.05)。治疗后VAS评分3组均明显低于治疗前(P<0.05),3组间比较差异无统计学意义(P>0.05)。结论3种术式治疗OVCF均有效;PCVP组骨水泥注入量和手术时间优于双侧PVP组,骨水泥分布均衡性优于单侧PVP组,说明PCVP治疗OVCF能够有效减少骨水泥注入量和手术时间,优化骨水泥分布,减轻患者的疼痛,改善骨折椎体的稳定性。

Objective To compare the curative effect and bone cement distribution of the treatment of osteoporotic vertebral compression fracture(OVCF)with percutaneous curved vertebroplasty(PCVP)and unilateral and bilateral percutaneous vertebroplasty(PVP).Methods The 90 OVCF patients were randomly divided into PCVP group,unilateral PVP group and bilateral PVP group,with 30 patients in each group.The surgery treatment related data,bone cement leakage rate,ideal distribution ratio of bone cement in the vertebrae,and pain VAS before and after treatment were compared among the three groups.Results All cases were followed up for 1 month.The bone cement injection volume and operation time in PCVP group and unilateral PVP group were less than those in bilateral PVP group(P<0.05).The differences of Cobb angle recovery rate of the three groups were not statistically significant(P>0.05).The ideal distribution ratio of bone cement in the vertebrae in PCVP group and bilateral PVP group were higher than that in unilateral PVP group(P<0.05).VAS of the three groups after treatment was significantly lower than that before treatment(P<0.05),and there was no statistical significance among the three groups after treatment(P>0.05).Conclusions All the three groups are effective.PCVP group has less(shorter)bone cement injection volume and operation time than bilateral PVP group,and the bone cement distribution is better than unilateral PVP group,which indicates that PCVP for treatment of OVCF can effectively reduce bone cement injection volume and operation time,optimize bone cement distribution,relieve pain of patients and improve stability of fractured vertebrae.