骨质疏松椎体骨折单侧与双侧椎体后凸成形术比较

Comparison of unilateral and bilateral kyphoplasty for osteoporotic vertebral compressive fractures

[目的]比较单双侧入路椎体后凸成形术(percutaneous kyphoplasty, PKP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compressive fracture, OVCF)的疗效。[方法]回顾分析2016年1月~2019年1月,本科PKP术治疗OVCF患者142例,其中,单侧入路72例,双侧入路70例。比较两组围手术期、随访与影像资料。[结果]单侧入路组手术时间、射线暴露时间、出血量及骨水泥量均显著优于双侧入路组(P<0.05),两组并发症发生率差异无统计学意义(P>0.05)。末次随访时两组的VAS评分和ODI评分均较术前显著降低(P<0.05),相应时间点两组间VAS评分和ODI评分的差异均无统计学意义(P>0.05)。与术前相比,两组末次随访时椎体前缘高度均显著增加(P<0.05),而局部Cobb角均显著减少(P<0.05)。相应时间点两组间椎体前缘高度和Cobb角的差异均无统计学意义(P>0.05)。[结论]与双侧入路PKP相比,单侧PKP可以减少手术时间和射线暴露时间,降低手术成本,减少手术创伤。

[Objective] To compare the efficacy of unilateral and bilateral kyphoplasty(PKP) in the treatment of osteoporotic vertebral compression fractures(OVCF). [Methods] From January 2016 to January 2019, 142 patients were treated with PKP for OVCF in our department, including 72 cases with unilateral approach and 70 cases with bilateral approach. The perioperative period, follow-up and imaging data were compared between the two groups. [Results] The unilateral approach group was significantly superior to the bilateral approach group in terms of operation time, radiation exposure time, blood loss and bone cement volume injected(P<0.05), but there was no statistically significant difference in the incidence of complications between the two groups(P>0.05). At the latest follow-up the VAS scores and ODI scores of the two groups were significantly lower than those before the operation(P<0.05). However, there were no significant differences in VAS scores and ODI scores between the two groups at the corresponding time points(P>0.05). Compared with those preoperatively,the anterior height of vertebral body significantly increased(P<0.05), while the local Cobb angle significantly decreased at the latest followup in both groups(P<0.05). There were no statistically significant differences in the anterior height of vertebral body and the Cobb angle between the two groups at the corresponding time points(P>0.05). [Conclusion] Compared with bilateral PKP, unilateral PKP does reduce the operation time and radiation exposure time, reduce the operation cost, and reduce the surgical trauma.