单侧入路PKP治疗老年女性骨质疏松性胸腰椎压缩骨折

Unilateral Approach PKP for the Treatment of Osteoporotic Thoracolumbar Compression Fractures in Elderly Female

目的分析老年女性骨质疏松性椎体压缩性骨折(OVCF)患者采用单侧椎弓根入路经皮球囊扩张椎体后凸成形术(PKP)治疗的临床效果。方法将2018年8月—2019年3月无锡市中医医院脊柱骨科收治的103例老年女性OVCF患者按照随机数表法分为观察组与对照组。用单侧椎弓根入路PKP对观察组患者进行治疗,用双侧椎弓根入路PKP对照组患者进行治疗,比较两组患者手术的时间、伤椎内骨水泥的注入量及Oswestry功能障碍指数问卷表(ODI)的评分。结果接受单侧椎弓根入路PKP治疗的患者,手术时间和骨水泥注入量较对照组患者显著减少,差异有统计学意义(P<0.05)。术后1个月,两组患者ODI评分均低于术前,差异有统计学意义(P<0.05)。但是在术后1个月,两组患者的ODI评分差异不显著(P>0.05)。结论单侧椎弓根入路PKP治疗老年女性OVCF患者是一种有效的治疗方法,它能够显著缩短手术时间,减少伤椎内骨水泥的注入量,促进胸腰椎功能的恢复。因此,对于老年女性OVCF患者,单侧椎弓根入路PKP是一个值得推荐的治疗方案。但是,由于样本量有限,未来需要进一步扩大样本量并作长期的随访。

Objective To analyze the clinical effect of unilateral pedicle approach percutaneous balloon expansion kyphoplasty(PKP)in elderly female patients with osteoporotic vertebral compression fracture(OVCF).Methods 103 elderly female patients with OVCF who were admitted to the Spine Department of Wuxi Hospital of Traditional Chinese Medicine from August 2018 to March 2019 were divided into observation group and control group according to random number table method.The observation group was treated with unilateral pedicle approach PKP and the control group with bilateral pedicle approach PKP.The time of operation,the amount of bone cement injected into the injured vertebra and the score of the Oswestry disability Index(ODI)were compared between the two groups.Results Compared with the control group,the time of operation and the amount of bone cement injection in the patients treated with unilateral pedicle approach PKP were significantly reduced,with statistical significance(P<0.05).One month after surgery,ODI scores in both groups were lower than before surgery(P<0.05).However,at one month after surgery,there was no significant difference in ODI scores between the two groups(P>0.05).Conclusion Unilateral pedicle approach PKP is an effective treatment for elderly female patients with OVCF.It can significantly shorten the operation time,reduce the amount of bone cement injected into the injured vertebra,and promote the recovery of thoracolumbar function.Therefore,unilateral pedicle approach PKP is a recommended treatment option for elderly women with OVCF.However,due to the limited sample size,further enlargement of the sample size and long-term follow-up are needed in the future.