PVP和PKP治疗老年骨质疏松性椎体压缩骨折的临床效果分析

Analysis on Clinical Effect of PVP and PKP in Treatment of Elderly Osteoporotic Vertebral Compression Fractures

目的:分析经皮椎体成形术(PVP)与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临床效果。方法:选取2017年4月—2020年4月郴州市中医医院收治的老年骨质疏松性椎体压缩骨折患者140例作为研究对象,根据随机数字表法分为PVP组(n=68)和PKP组(n=72)。PVP组实施PVP治疗,PKP组实施PKP治疗。比较两组手术指标、疼痛情况、腰椎功能、影像学指标、不良事件发生情况。结果:PKP组手术透视次数、注入骨水泥量大于PVP组,手术时间长于PVP组,差异有统计学意义(P<0.001);两组术中出血量比较,差异无统计学意义(P>0.05)。术前、术后1 d、术后6个月、术后12个月,两组视觉模拟评分法(VAS)、腰椎功能障碍指数(ODI)评分比较,差异无统计学意义(P>0.05);术后1 d、术后6个月、术后12个月,两组VAS、ODI评分均低于术前,差异有统计学意义(P<0.05)。术前,两组Cobb角、椎体前缘高度比较,差异无统计学意义(P>0.05);术后1 d、术后12个月,两组Cobb角均小于术前,且PKP组小于PVP组,两组椎体前缘高度均高于术前,且PKP组高于PVP组,差异有统计学意义(P<0.05)。两组不良事件总发生率比较,差异无统计学意义(P>0.05)。结论:PVP和PKP治疗老年骨质疏松性椎体压缩骨折的临床效果均较好,均能缓解患者疼痛,改善腰椎功能,且安全性较高。但PVP术中透视次数、骨水泥用量少,手术时间短;PKP更利于恢复伤椎高度、纠正椎体Cobb角。

Objective:To analyze the clinical effect of percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in the treatment of elderly osteoporotic vertebral compression fractures.Methods:A total of 140 elderly patients with osteoporotic vertebral compression fractures who were admitted to Chenzhou Municipal Hospital of Traditional Chinese Medicine from April 2017 to April 2020 were selected as the study subjects.They were divided into PVP group(n=68)and PKP group(n=72)according to the random number table method.PVP group implemented PVP treatment and PKP group implemented PKP treatment.The surgical indicators,pain,lumbar vertebral function,imaging indexes,and adverse events were compared between the two groups.Results:The number of intraoperative fluoroscopy and the amount of bone cement injected in the PKP group were higher than those in the PVP group,and the operation time in the PKP group was longer than that in the PVP group,and the difference was statistically significant(P<0.001).There was no significant difference in intraoperative blood loss between the two groups(P>0.05).There was no significant difference in the scores of visual analogue scale(VAS)and lumbar dysfunction index(Oswestry Disability Index,ODI)between the two groups before surgery,on 1 d after surgery,at 6 months after surgery and at 12 months after surgery(P>0.05).On 1 d after surgery,at 6 months after surgery and at 12 months after surgery,the VAS and ODI scores in the two groups were lower than those before surgery,and the difference was statistically significant(P<0.05).Before surgery,there was no significant difference in the Cobb angle and anterior vertebral height between the two groups(P>0.05).On 1 d after surgery and at 12 months after surgery,the Cobb angle in two groups was smaller than that before surgery,and the Cobb angle in the PKP group was smaller than that in the PVP group,while the anterior vertebral height in two groups was higher than that before surgery,and the anterior vertebral height in the PKP group was higher than that in the PVP group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse events between the two groups(P>0.05).Conclusion:Both PVP and PKP have good clinical effects in the treatment of elderly osteoporotic vertebral compression fractures,and they can relieve pain,improve lumbar vertebral function,and have a high safety.However,PVP has a lower number of intraoperative fluoroscopy and amount of bone cement,as well as a shorter operation time.PKP is more conducive to recovering the height of the injured vertebral vertebrae and correcting the Cobb angle of the vertebral body.