弯角经皮椎体成形术与经皮椎体成形术治疗陈旧骨质疏松性椎体压缩骨折的疗效比较

Comparison of the efficacy of PCVP and PVP in the treatment of old OVCF

目的比较弯角经皮椎体成形术(percutaneous curved vertebroplasty,PCVP)与经皮椎体成形术(percutaneous vertebraplasty,PVP)治疗陈旧骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)的临床疗效。方法回顾性分析PCVP与PVP治疗的58例陈旧胸腰段脊柱OVCF,其中28例采用PCVP治疗记为观察组,30例采用PVP治疗记为对照组。记录2组术中透视次数、手术时间、骨水泥用量、骨水泥分布等级、骨水泥渗漏率、Oswestry功能障碍指数(Oswestry dysfunction index,ODI)评分、疼痛视觉模拟(pain visual simulation,VAS)评分。结果两组术中透视次数、手术时间、骨水泥渗漏率比较,差异均无统计学意义(P>0.05)。观察组骨水泥用量大于对照组,骨水泥分布等级优于对照组,差异均有统计学意义(P<0.05)。两组术后ODI评分、VAS评分比较,差异均有统计学意义(P<0.05);且与术前比较,差异均有统计学意义(P<0.05)。结论PCVP治疗陈旧OVCF安全有效,可较PVP注入更多的骨水泥,使其达到更好的双侧分布;而且缓解疼痛、改善脊柱功能更显著。

Objective To compare the clinical efficacy of percutaneous curved vertebroplasty(PCVP)and percutaneous vertebroplasty(PVP)in the treatment of old osteoporotic vertebral compression fractures(OVCF).Methods A retrospective analysis of 58 cases of old thoracolumbar spinal OVCF treated with PCVP and PVP,28 cases with PCVP treatment were recorded as the observation group,and 30 cases with PVP treatment as the control group.The number of intraoperative fluoroscopy,operation time,bone cement dosage,bone cement distribution grade,bone cement leakage rate,Oswestry dysfunction index(ODI)score,and pain visual simulation(VAS)score were recorded in the two groups.Results All 58 patients successfully completed the operation.There was no significant difference in the number of intraoperative fluoroscopy,operation time,and bone cement leakage rate between the two groups(P>0.05).The bone cement dosage in the observation group was greater than that in the control group,and the grade of bone cement distribution was better than that of the control group,and the differences were statistically significant(P<0.05).The difference between the two groups of postoperative ODI score and VAS score was statistically significant(P<0.05);and compared with preoperatively,the difference was statistically significant(P<0.05).Conclusion PCVP is safe and effective in treating old OVCF.It can inject more bone cement than PVP to achieve better bilateral distribution;it also relieves pain and improves spinal function more significantly.