OVCF中单侧椎弓根旁或双侧经椎弓根入路PKP应用效果分析

Effect Analysis of PKP by Unilateral or Bilateral Transpedicular Approach in OVCF

目的分析骨质疏松性椎体压缩骨折(OVCF)中单侧椎弓根旁或双侧经椎弓根入路经皮椎体后凸成形术(PKP)应用效果。方法随机数字表法将2017年1月至2019年3月期间纳入的盘锦市中心医院84例OVCF患者分为对照组(双侧经椎弓根PKP)和观察组(单侧椎弓根旁PKP),记录术中透视次数、出血量、骨水泥注射量、手术时间、住院天数以及不同时间VAS分值、ODI分值、伤椎椎体前缘高度、后凸Cobb角、骨水泥渗漏发生率。结果与对照组相比,观察组术中透视次数、出血量、骨水泥注入量更少,手术耗时更短,P<0.05两组住院时间比较,P>0.05。两组术后72 h、6个月VAS和DOI均下降(P<0.05),两组AVH均升高,Cobb减小;但两组各时间段上述指标比较均为P>0.05。观察组骨水泥渗漏率(14.29%)较对照组(30.95%)低,P<0.05。结论两种入路PKP均能缓解患者疼痛,矫正后凸,调整伤椎椎体高度,改善功能的作用,二者效果相似,但单侧经椎弓根旁入路PKP能缩短手术时间,减少创伤、透视次数和骨水泥注射以及骨水泥漏出,安全性更优。

Objective To analyze the effect of unilateral transpedicular approach or bilateral percutaneous kyphoplasty(PKP)in osteoporotic vertebral compression fractures(OVCF).Methods 84 patients with OVCF in Panjin Central Hospital from January 2017 to March 2019 were randomly divided into the control group(bilateral transpedicular PKP)and the observation group(unilateral parapedicle PKP).Intraoperative fluoroscopy times,blood loss,bone cement injection volume,operation time,hospitalization days,VAS score,ODI score,anterior height of injured vertebral body and kyphosis Cobb angle,and incidence of bone cement leakage were recorded.Results The observation group had fewer intraoperative fluoroscopy times,less blood loss,less bone cement injection volume and shorter operation time than the control group(P<0.05).The hospitalization time of the two groups got compared(P>0.05).VAS and DOI decreased 72 hours and 6 months after operation in both groups(P<0.05),while AVH increased and Cobb decreased in both groups.However,the above indexes were all P>0.05.The leakage rate of bone cement in the observation group(14.29%)was lower than that in the control group(30.95%)(P<0.05).Conclusion Both approaches of PKP can relieve pain,correct kyphosis,adjust the height of injured vertebrae and improve the function of patients.The two approaches have similar effects,but PKP by unilateral transpedicular lateral approach can shorten the operation time,reduce the trauma,fluoroscopy times,bone cement injection and cement leakage,which is much safer.