单侧PVP术对OVCF术后椎体高度恢复及疼痛程度的效果研究

Effect of unilateral PVP on vertebral height recovery and the degree of pain score after surgery in patients with OVCF

目的探讨采用单侧经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折(OVCF)术后的椎体高度恢复及疼痛情况。方法选取2016年9月—2019年9月江苏省泰州市第二人民医院行PVP治疗的胸腰椎单椎体OVCF患者84例,根据手术入路分为单侧组和双侧组,其中单侧组48例,双侧组36例。比较两组手术时间、术中透视次数、骨水泥注入量。比较两组术前及术后3 d、术后1年的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、椎体高度及Cobb角的变化。结果单侧组手术时间短与双侧组,术中X线透视次数少于双侧组,骨水泥注入量低于双侧组,差异均有统计学意义(均P<0.05)。两组术前及术后3 d、术后1年的VAS、ODI评分的组间比较、时间点比较差异均有统计学意义(P<0.05)。进一步两两比较,两组术后3 d及1年的VAS、ODI评分均低于术前,且术后1年均低于术后3 d,差异均有统计学意义(均P<0.05)。单侧组术后3 d的VAS、ODI评分均低于同一时间点的双侧组,差异均有统计学意义(均P<0.05)。两组术前及术后3 d、术后1年的椎体高度、Cobb角的时间点比较及交互作用差异均有统计学意义(P<0.05)。进一步两两比较:两组术后3 d及术后1年椎体高度均高于术前,Cobb角小于术前,且术后1年椎体高度低于术后3 d,Cobb角大于术后3 d,差异均有统计学意义(均P<0.05)。结论采用单侧与双侧PVP治疗OVCF,均能取得了良好的临床效果,单侧入路更具有优势,其在手术时间、X线透视次数等方面明显优于双侧入路。

Objective To investigate the recovery of vertebral height and the degree of pain after unilateral percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fracture(OVCF).Methods A total of 84 patients with thoracolumbar single vertebral body OVCF who received PVP treatment in Taizhou Second People’s Hospital,Jiangsu Province from September 2016 to September 2019 were selected.According to the surgical approach,they were divided into unilateral group and bilateral group,including 48 cases in unilateral group and 36 cases in bilateral group.The surgical time,surgical fluoroscopy times and the amount of bone cement injection were compared between the two groups.The changes of visual analogue score(VAS),Oswestry disability index(ODI),vertebral height and Cobb angle were compared between the two groups before and three days after surgery and one year after surgery.Results The times of surgical X-ray fluoroscopy in unilateral group was less than that in bilateral group,and the amount of bone cement injection was lower than that in bilateral group,with statistical significance(all P<0.05).There were statistically significant differences in VAS and ODI scores between the two groups before and three days after surgery,and one year after surgery,as well as at time points(P<0.05).Further pairwise comparison showed that VAS and ODI scores at three days and one year after surgery were lower than those before surgery,and one year after surgery were lower than those at three days after surgery,with statistical significance(all P<0.05).VAS and ODI scores of the unilateral group were lower than those of the bilateral group at the same time point,and the differences were statistically significant(all P<0.05).There were statistically significant differences in the time point comparison and interaction of vertebral height,Cobb angle between the two groups before and three days and one year after surgery(P<0.05).Fur ther pairwise comparison:the vertebral height at three days and one year after surgery in both groups was higher than before surgery,Cobb angle was lower than before surgery,and the vertebral height at one year after surgery was lower than three days after surgery,Cobb angle was greater than three days after surgery,the differences were statistically significant(all P<0.05).Conclusion Both unilateral and bilateral PVP were used in the treatment of OVCF,and the unilateral approach was more advantageous than the bilateral approach in terms of surgry time and number of X-ray fluoroscopy.