高龄骨质疏松性胸腰椎压缩骨折椎体增强术

Vertebral augmentation for thoracolumbar osteoporotic vertebral compression fractures in the elderly

[目的]比较经皮椎体成形术(percutaneous vertebroplasty,PVP)与经皮后凸成形术(percutaneous kyphoplasty,PKP)治疗高龄骨质疏松性胸腰椎椎体压缩性骨折(osteoporotic vertebral compression fracture,0VCF)的早期临床效果。[方法]回顾性分析本科2019年1月-2020年1月采用椎体增强术治治疗0VCF患者152例,其中,PVP术70例,PKP术82例。比较两组临床与影像资料。[结果]PVP组手术时间短于PKP组(P<0.05),但两组在骨水泥注入量和骨水泥渗漏率的差异无统计学意义(P>0.05)。随时间推移,两组VAS和0DI评分均显著下降(P<0.05),相应时间点,两组间VAS和0DI评分的差异均无统计学意义(P>0.05)。影像方面,术后3d和术后6个月时PKP组在伤椎前缘高度和后凸Cobb角均显著优于PVP组(P<0.05)。[结论]PVP手术用时短,而PKP更利于改善伤椎高度及Cobb角。

[Objective]To compare the short-term outcomes of percutaneous vertebroplasty(PVP)versus percutaneous kyphoplasty(PKP)for osteoporotic vertebral compression fractures(OVCF)in the elderly.[Methods]A retrospective study was conducted on 152 patients who underwent vertebral augmentation for OVCF in our department from January 2019 to January 2020.Of them,70 patients received PVP,while the remaining 82 patients underwent PKP.The clinical and radiographic documents in early stage were compared be-tween the two groups.[Results]The PVP group consumed significantly shorter operation time than the PKP group(P<0.05),nevertheless there was no significant difference in the amount of bone cement injected and bone cement leakage rate between the two groups(P>0.05).The VAS and ODI scores decreased significantly in both groups over time(P<0.05).At any corresponding time point,the difference in VAS and ODI scores between the two groups was not statistically significant(P>0.05).Regarding to imaging evaluation,the PKP group was significantly superior to the PVP group in terms of the anterior height of the injured vertebrae and kyphotic Cobb's angle at 3 days and 6 months after operation(P<0.05).[Conclusion]PVP surgery takes a short time for surgical operation,while PKP is more conducive to improving the anterior height of the injured vertebrae and kyphotic Cobb's angle.