比较分析单侧穿刺与双侧穿刺行骨质疏松性椎体骨折椎体成形术的疗效分析

Comparative Analysis of the Curative Effect of Unilateral Puncture and Bilateral Puncture for Vertebroplasty for Osteoporotic Vertebral Frac⁃tures

目的对比采用单侧穿刺或双侧穿刺椎体成形术(PVP)治疗骨质疏松性椎体骨折的效果,旨在探讨更为理想的治疗方案。方法方便选取该院骨科2019年1月—2021年7月收治的96例骨质疏松性椎体骨折患者,方便以随机数表法分为对照组和研究组,每组48例。对照组患者采用双侧经皮穿刺PVP治疗,研究组采用单侧经皮穿刺PVP治疗。对比观察两组患者围手术指标、术前术后伤椎椎体高度压缩率变化情况、椎体后凸Cobb角变化与患者肢体功能恢复情况,同时统计两组术后手术相关并发症发生情况。结果两组术后住院时间比较,差异无统计学意义(P>0.05),研究组术中出血量、骨水泥注入量少于对照组,差异有统计学意义(t=4.370、6.400,P<0.05),研究组手术时间,X线暴露时间短于对照组,差异有统计学意义(t=4.899、9.149,P<0.05)。术后患者椎体高度压缩率、椎体后凸Cobb角均小于术前,ODI评分低于术前,差异有统计学意义(P<0.05),而两组上述指标比较,差异无统计学意义(P>0.05)。研究组并发症发生率(2.08%)低于对照组(16.67%),差异有统计学意义(χ^(2)=4.414,P<0.05)。结论单侧穿刺与双侧穿刺行PVP治疗骨质疏松性椎体骨折均能够获得良好的效果,2种术式疗效相当,但单侧穿刺具有手术时间短、微创性更好及安全性更高等优势。

Objective To compare the effect of unilateral puncture or bilateral puncture vertebroplasty(PVP)in the treatment of osteoporotic vertebral fractures,in order to explore a more ideal treatment plan.Methods A total of 96 pa⁃tients with osteoporotic vertebral fractures admitted to the Department of Orthopedics in the hospital from January 2019 to July 2021 were conveniently selected,and then divided into a control group and a study group by random number table method,with 48 cases in each group.The patients in the control group were treated with bilateral percu⁃taneous PVP,and the patients in the study group were treated with unilateral percutaneous PVP.The perioperative indexes,the changes of the vertebral body height compression rate before and after surgery,the changes of the Cobb angle of kyphosis and the recovery of limb function of the patients were compared between the two groups.Results There was no statistically significant difference in postoperative hospital stay between the two groups(P>0.05).The intraoperative blood loss and bone cement injection volume in the study group were less than those in the control group,and the difference was statistically significant(t=4.370,6.400,P<0.05),the operation time and X-ray expo⁃sure time of the study group were shorter than those of the control group,and the difference was statistically signifi⁃cant(t=4.899,9.149,P<0.05).The vertebral height compression rate and kyphotic Cobb angle of the patients after operation were lower than those before operation,and the ODI score was lower than that before operation,and the dif⁃ference was statistically significant(P<0.05),and there was no statistically significant difference in the above indica⁃tors between the two groups(P>0.05).The incidence of complications in the study group(2.08%)was lower than that in the control group(16.67%),and the difference was not statistically significant(χ^(2)=4.414,P<0.05).Conclusion Uni⁃lateral puncture and bilateral puncture with PVP can achieve good results in the treatment of osteoporotic vertebral fractures.The curative effects of the two surgical methods are comparable,but unilateral puncture has the advantages of shorter operation time,better minimally invasiveness and higher safety.