单、双侧经皮穿刺椎体后凸成形术治疗胸腰段骨质疏松性椎体压缩骨折的疗效比较

Comparison of the effects ofunipedicular and bipedicular percutaneous PKP in the treatment of osteoporotic vertebral compression fractures

目的评价单、双侧椎弓根入路经皮穿刺椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性压缩骨折的临床疗效。方法回顾分析本院2017年1月-2019年1月行PKP手术治疗的骨质疏松性压缩性胸腰椎骨折患者63例,采用随机数字法分为两组:A组30例,采用单侧椎弓根入路;B组33例,采用双侧椎弓根入路。对两组患者术后椎体矫正情况及手术前后、随访期间的VAS评分进行比较。结果双侧穿刺组手术时间及手术中透视次数明显高于单侧穿刺组,差异有统计学意义(P<0.05);两组骨水泥灌注量差异无统计学意义(P>0.05)。两组术后1个月的椎体高度重建率及Cobb角改善率比较,差异无统计学意义(P>0.05)。两组患者的术后3 d、3个月、6个月及12个月的VAS评分显著低于术前(P<0.05),但两组间差异无统计学意义(P>0.05)。结论单、双侧入路PKP手术均可取得良好疗效。单侧入路手术时间相对较短,透视次数较少。

Objective To evaluate the clinical efficacy of percutaneous kyphoplasty(PKP)through unilateral and bilateral pedicle approach in the treatment of osteoporotic compression fractures.Methods From January 2017 to January 2019,63 patients with osteoporotic compression thoracolumbar fractures treated by PKP in our hospital were selected and randomly divided into two groups:group A(30 cases)was treated with unilateral pedicle approach;group B(33 cases)was treated with bilateral pedicle approach.The postoperative vertebral correction,VAS score before and after operation and during follow-up were compared between the two groups.Results The operation time and fluoroscopy times in the bilateral puncture group were significantly higher than those in the unilateral puncture group,the difference was statistically significant(P<0.05).There was no significant difference in bone cement perfusion between the two groups(P>0.05).There were no significant differences in vertebral height reconstruction rate and Cobb angle improvement rate between the two groups at 1 month after operation(P>0.05).The VAS scores at 3 days,3 months,6 months and 12 months after operation in the two groups were significantly lower than before operation(P<0.05),but there were no significant differences between the two groups(P>0.05).Conclusion Both unilateral and bilateral PKP can achieve good results.The operation time of unilateral approach is relatively short,and the number of fluoroscopy is less.