单、双侧入路PKP治疗合并远节段腰背痛OVCF的早期效果分析

Early Effect Analysis of Single and Bilateral Approach PKP in Treatment of OVCF with Distal Low Back Pain

目的:探讨双侧和单侧两种入路经皮椎体后凸成形术(PKP)治疗合并远节段腰背痛骨质疏松性椎体骨折(OVCF)的早期效果。方法:回顾性分析2015年7月-2019年12月在笔者所在医院采用PKP治疗的合并远节段腰背痛OVCF患者共68例,根据治疗方式不同分为两组,其中A组(单侧入路组)31例,B组(双侧入路组)37例。比较两组术前及术后3 d疼痛视觉模拟评分法(VAS)评分、骨折椎体畸形指数及后凸率。结果:术后3 d两组VAS评分、畸形指数及后凸率均优于术前,B组VAS评分低于A组,畸形指数高于A组,差异均有统计学意义(P<0.05),但两组后凸率对比差异无统计学意义(P>0.05)。结论:两种入路方式PKP均能在OVCF的治疗中起到显著效果,但双侧入路PKP能够更好地恢复骨折椎体的整体高度,更大程度缓解因骨折诱发的远节段腰背痛。

Objective:To investigate the early effect of bilateral and unilateral percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture (OVCF) with distal low back pain.Method:A retrospective analysis was performed on 68 patients with OVCF complicated with distal low back pain who received PKP treatment in the author’s hospital from July 2015 to December 2019,and they were divided into two groups according to different treatment methods,including group A (unilateral approach group) with 31 cases,and group B (bilateral approach group) with 37 cases.Visual analogue scale (VAS) score,fracture vertebra deformity index and kyphosis rate were compared between the two groups before and 3 days after surgery.Result:The VAS score,deformity index and kyphosis rate in the two groups were better than those before surgery,the VAS score in group B was lower than that in group A,and the deformity index was higher than that ingroup A,the differences were statistically significant (P<0.05),but there was no significant difference in kyphosis between the two groups (P>0.05).Conclusion:Both of two approaches of PKP can play a significant role in the treatment of OVCF,but the bilateral approach of PKP can better restore the overall height of the fractured vertebral body and relieve the distal low back pain caused by fracture to a greater extent.