单、双侧穿刺经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的疗效比较

Effect comparison of percutaneous kyphoplasty with unilateral and bilateral puncturing for osteoporotic vertebral compression fractures in the elderly

目的比较单、双侧穿刺经皮椎体后凸成形术(PKP)治疗老年骨质疏松性椎体压缩骨折的疗效。方法将62例行PKP治疗的老年骨质疏松性椎体压缩骨折患者按单、双侧穿刺不同分为单侧组(32例)和双侧组(30例)。比较两组骨水泥注入量及渗漏情况、术中X线透视时间、手术时间、术后疼痛VAS评分以及影像学指标。结果患者均获得随访,时间6~13个月。骨水泥注入量、术中X线透视时间、手术时间单侧组均少(短)于双侧组(P<0.01)。术后疼痛VAS评分两组比较差异无统计学意义(P>0.05)。单侧组3例、双侧组7例发生骨水泥渗漏,但均无临床症状。伤椎前缘高度、伤椎中央高度、Cobb角两组术后均较术前改善(P<0.05),两组术后比较差异均无统计学意义(P>0.05)。结论单、双侧穿刺PKP治疗老年骨质疏松性椎体压缩骨折均能改善患者疼痛症状、纠正脊柱后凸畸形,恢复伤椎高度,单侧穿刺术中X线透视时间和手术时间更短、骨水泥注入量更少。

Objective To compare the efficacy of percutaneous kyphoplasty(PKP)with unilateral and bilateral puncturing for treatment of the osteoporotic vertebral compression fracture(OVCF)in the elderly.Methods The 62 elderly patients with OVCFs who underwent PKP treatment were divided into unilateral group(32 cases)and bilateral group(30 cases),according to unilateral and bilateral puncture.The volume of bone cement injection and leakage status,intraoperative X-ray fluoroscopy time,operation time,postoperative pain VAS and imaging indexes were compared between the two groups.Results All patients were followed up for 6~13 months.The volume of bone cement injection,intraoperative X-ray fluoroscopy time and operation time were less(shorter)in unilateral group than bilateral group(P<0.01).There was no statistical difference in postoperative pain VAS between the two groups(P>0.05).Bone cement leakage occurred in 3 cases in unilateral group and 7 cases in bilateral group,but there were no clinical symptoms.At postoperation,the anterior margin height of the injured vertebrae,the central height of the injured vertebrae and the Cobb angles of the two groups were improved than the preoperation(P<0.05),and there were no statistical differences between the two groups after surgery(P>0.05).Conclusions Both unilateral and bilateral puncturing PKP for treatment of elderly patients with OVCFs,which can improve patient′s pain symptoms,and correct kyphosis deformity,restore the height of the injured vertebrae,and there are shorter time of X-ray fluoroscopy and operation time,and less volume of bone cement injection in unilateral puncture.