PKP与PVP治疗骨质疏松椎体压缩性骨折的临床效果

Clinical effects of PKP and PVP in the treatment of osteoporotic vertebral compression fractures

目的探讨经皮椎体后凸成形术(PKP)与经皮椎体成形术(PVP)治疗骨质疏松椎体压缩性骨折的临床效果。方法回顾性分析2017年5月至2018年4月收治的96例骨质疏松椎体压缩性骨折患者的临床资料,按照手术方式的不同分为PKP组(41例)和PVP组(55例)。比较两组的手术时间、骨水泥注入量、骨水泥渗漏个数、住院时间及医疗费用;随访至术后1年,比较两组的VAS、ODI评分和Cobb角。结果 PKP组的手术时间长于PVP组,骨水泥注入量大于PVP组,医疗费用高于PVP组,差异具有统计学意义(P<0.05)。两组的骨水泥渗漏个数、住院时间及各时间点的VAS、ODI评分比较,差异无统计学意义(P>0.05)。术后各时间点PKP组的Cobb角小于PVP组,差异具有统计学意义(P<0.05)。结论 PKP与PVP均可有效缓解骨质疏松椎体压缩性骨折患者的疼痛程度、提高生活质量。PKP在矫正患者脊柱后凸畸形方面的效果优于PVP,但其会明显增加手术时间及医疗费用,故在临床治疗过程中应权衡利弊选择治疗方案。

Objective To explore the clinical effects of percutaneous kyphoplasty(PKP)and percutaneous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fractures.Methods The clinical data of 96 patients with osteoporotic vertebral compression fractures from May 2017 to April 2018 were analyzed retrospectively,and the patients were divided into PKP group(41 cases)and PVP group(55 cases)according to different surgical methods.The operation time,the amount of bone cement injection,the number of bone cement leakage,the hospital stay and medical expenses were compared between the two groups;follow-up to 1 year after surgery,the VAS,ODI scores and Cobb angle of the two groups were compared.Results The operation time of the PKP group was longer than that of the PVP group,the amount of bone cement injection was greater than that of the PVP group,and the medical expenses was higher than that of the PVP group,and the differences were statistically significant(P<0.05).There were no significant differences in the number of bone cement leakage,hospital stay,and VAS and ODI scores at each time point between the two groups(P>0.05).At each time point after operation,the Cobb angle of the PKP group was smaller than that of the PVP group,and the difference was statistically significant(P<0.05).Conclusion Both PKP and PVP can effectively relieve the pain of patients with osteoporotic vertebral compression fractures and improve the quality of life.PKP is better than PVP in correcting patients with kyphosis,but it will significantly increase the operation time and medical expenses.Therefore,the pros and cons should be weighed in the clinical treatment process to choose a treatment plan.