椎体成形术与椎体后凸成形术治疗Kummell病的临床效果比较

Comparison of the Clinical Effects of Vertebroplasty and Kyphoplasty in Treatment of Kummell Disease

目的:比较椎体成形术(percutaneous vertebroplasty,PVP)与椎体后凸成形术(percutaneous kyphoplasty,PKP)运用在Kummell病治疗中的临床效果。方法:选取2015年1月-2020年1月笔者所在医院接诊的120例Kummell病患者,以随机数字表法分为PVP组(共60例,行PVP治疗)、PKP组(共60例,行PKP治疗),对两组临床参数、功能障碍指数、疼痛情况、椎体前缘高度进行对比。结果:PVP组手术时间短于PKP组,骨水泥注入量、住院费用均低于PKP组,PVP组骨水泥渗漏率高于PKP组,差异均有统计学意义(P<0.05);两组术前、术后1 d及末次随访时ODI评分、VAS评分比较差异均无统计学意义(P>0.05);术后1 d、末次随访时,PVP组椎体前缘高度均低于PKP组,差异均有统计学意义(P<0.05)。结论:在Kummell病治疗中,PVP具有手术创伤小、手术时间短等优势,但容易发生骨水泥渗漏,而PKP复位效果更好。

Objective:To compare the clinical effects of percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in treatment of Kummell disease.Method:A total of 120 patients with Kummell disease treated in our hospital from January 2015 to January 2020 were selected,they were divided into the PVP group(60 patients received PVP treatment)and the PKP group(60 patients received PKP treatment)by random number table method.The clinical parameters,dysfunction index,pain and anterior vertebral height of the two groups were compared.Result:The operation time in the PVP group was shorter than that in the PKP group,and the amount of bone cement injection and hospitalization cost were lower than those in the PKP group,the rate of bone cement leakage in the PVP group was higher than that in the PKP group,the differences were statistically significant(P<0.05).There were no significant differences in ODI score and VAS score between the two groups before surgery,1 day after surgery and at the last follow-up(P>0.05).At 1 day after surgery and the last follow-up,the anterior vertebral margin height in the PVP group was lower than that in the PKP group,the differences were statistically significant(P<0.05).Conclusion:In treatment of Kummell disease,PVP has the advantages of less surgical trauma and short operation time,but it is prone to bone cement leakage,and PKP has a better reduction effect.