经皮椎体后凸成形术与经皮椎体成形术治疗骨质疏松性椎体压缩骨折患者的效果比较

Comparison of effects of percutaneous kyphoplasty and percutaneous vertebroplasty in treatment of patients with osteoporotic vertebral compression fractures

目的:比较经皮椎体后凸成形术(PKP)与经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折(OVCF)患者的效果。方法:回顾性分析2018年2月至2022年3月该院收治的98例OVCF患者的临床资料,按照手术方法不同将其分为观察组与对照组各49例。对照组行PVP治疗,观察组行PKP治疗。比较两组手术相关指标(透视次数、手术时间、骨水泥用量、治疗费用)水平、手术前后椎体功能[Oswestry功能障碍指数(ODI)]评分、影像学指标(Cobb角、伤椎前缘高度比)水平、疼痛介质指标[神经肽Y(NPY)、P物质、前列腺素E_(2)(PGE_(2))]水平和并发症发生率。结果:观察组透视次数、骨水泥用量、治疗费用均多于对照组,手术时间长于对照组,差异有统计学意义(P<0.05);术后1、3个月,观察组ODI评分低于对照组,Cobb角小于对照组,伤椎前缘高度比大于对照组,差异有统计学意义(P<0.05);术后7 d,观察组P物质、NPY、PGE_(2)水平均低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为2.04%(1/49),低于对照组的16.33%(8/49),差异有统计学意义(P<0.05)。结论:PKP治疗OVCF患者可降低疼痛介质指标水平、ODI评分和并发症发生率,改善影像学指标水平,效果优于PVP治疗效果,但需增加透视次数、骨水泥用量、治疗费用和手术时间。

Objective:To compare effects of percutaneous kyphoplasty(PKP)and percutaneous vertebroplasty(PVP)in treatment of patients with osteoporotic vertebral compression fractures(OVCF).Methods:The clinical data of 98 patients with OVCF admitted to the hospital from February 2018 to March 2022 were retrospectively analyzed.They were divided into observation group and control group according to different surgical methods,49 cases in each.The control group was treated with PVP,while the observation group was treated with PKP.The operation related index levels(number of fluoroscopy,operation time,bone cement dosage,treatment cost),the vertebral function[Oswestry dysfunction index(ODI)]score before and after the surgery,the imaging index levels(Cobb angle,anterior vertebral height ratio of injured vertebral body),the pain mediator levels[neuropeptide Y(NPY),substance P,prostaglandin E_(2)(PGE_(2))],and the incidence of complications were compared between the two groups.Results:The number of fluoroscopy,the bone cement dosage and the treatment cost in the observation group were more than those in the control group,the operation time was longer than that in the control group,and the differences were statistically significant(P<0.05).1 and 3 months after the surgery,the ODI scores of the observation group were lower than those of the control group,the Cobb angle was smaller than that of the control group,the anterior vertebral height ratio was higher than that of the control group,and the differences were statistically significant(P<0.05).7 days after the surgery,the levels of substance P,NPY and PGE_(2) in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 2.04%(1/49),which was lower than 16.33%(8/49)in the control group,and the difference was statistically significant(P<0.05).Conclusions:PKP in the treatment of the OVCF patients can reduce the levels of pain mediators,the ODI scores and the incidence of complications,and improve the levels of imaging indicators.It is superior to PVP.However,the number of fluoroscopy,the bone cement dosage,the treatment cost and the operation time can be increased.