PVP术与PKP术治疗重度骨质疏松性椎体压缩骨折的疗效及安全性分析

Efficacy and safety analysis of PVP and PKP in the treatment of severe osteoporotic vertebral compression fractures

目的对比分析经皮椎体成形术(PVP)与经皮椎体后凸成形术(PKP)治疗重度骨质疏松性椎体压缩骨折(OVCF)的疗效及安全性。方法回顾性分析万载县人民医院2020年1月-2023年1月收治的62例重度OVCF患者临床资料,根据手术方式不同分为两组,对照组(n=30)行PVP,观察组(n=32)行PKP。比较两组椎体压缩程度、腰椎活动功能、疼痛程度、椎体高度、Cobb角、并发症。结果术前,两组椎体压缩程度、腰椎活动功能、疼痛程度、椎体高度、Cobb角比较,无统计学差异(P>0.05);观察组术后3个月椎体压缩程度优于对照组,日本骨科协会评分(JOA)高于对照组,Oswestry功能障碍指数(ODI)低于对照组,视觉模拟评分(VAS)低于对照组,椎体中线高度、椎体前缘高度均高于对照组,Cobb角低于对照组,差异有统计学意义(P<0.05);与对照组(30.00%)并发症发生率比较,观察组(9.38%)较低,有统计学差异(P<0.05)。结论与PVP相比,PKP治疗重度OVCF在减轻疼痛及椎体压缩程度、改善腰椎活动功能等方面效果较好,利于减少并发症,加快术后恢复进程。

Objective To analyze the efficacy and safety of percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in the treatment of severe osteoporotic vertebral compression fracture(OVCF).Methods The clinical data of 62 patients with severe OVCF admitted from January 2020 to January 2023 were retrospectively analyzed.They were divided into two groups.The control group(n=30 patients)underwent PVP,and the observation group(n=32 patients)performed PKP.The degree of vertebral compression,lumbar mobility function,pain level,vertebral height,Cobb angle,and complications were compared between the two groups.Results In advance of the surgery,degree of vertebral compression,lumbar mobility function,pain,vertebral height and Cobb angle were compared,and there was no statistical difference(P>0.05);The vertebral compression in the observation group was better than that of the control group.The Japanese Orthopaedic Association Evaluation Form(JOA)score was higher than the control group.Oswestry Functional dysfunction index questionnaire(ODI)score was lower than the control group.Visual analog scoring method(VAS)score was lower than the control group.The height of the vertebral body midline and the anterior edge of the vertebral body were higher than that of the control group.The Cobb angle was lower than that in the control group.The differences were statistically significant(P<0.05).Compared with the control group(30.00%),the observation group(9.38%)had a lower complication rate,and there were statistical differences(P<0.05).Conclusion Compared with PVP,PKP treatment of severe OVCF has better results in reducing pain,vertebral compression degree and improving lumbar mobility function,which is conducive to reducing complications and accelerating the postoperative recovery process.