经皮椎体成形术与经皮椎体后凸成形术治疗脊柱转移瘤合并病理性骨折患者的临床疗效比较

Comparison of clinical efficacy of percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of patients with spinal metastasis tumors complica ted with pathological fracture

目的比较经皮椎体成形术(PVP)与经皮椎体后凸成形术(PKP)治疗脊柱转移瘤合并病理性骨折患者的临床疗效。方法根据治疗方式的不同将86例脊柱转移瘤合并病理性骨折患者分为PVP组(n=40,PVP联合射频消融术)和PKP组(n=46,PKP联合射频消融术)。比较两组患者的疼痛程度[视觉模拟评分法(VAS)]、脊柱稳定性、脊髓神经功能改善情况、临床疗效、术后并发症发生情况及复发率。结果术后,两组患者VAS评分均低于本组术前,Cobb角均小于本组术前,PKP组患者VAS评分低于PVP组,Cobb角小于PVP组,差异均有统计学意义(P﹤0.05)。术后,PKP组患者脊髓神经功能优于PVP组,差异有统计学意义(P﹤0.05)。PKP组患者的总有效率高于PVP组,差异有统计学意义(P﹤0.05)。两组患者的术后并发症发生总发生率比较,差异无统计学意义(P﹥0.05)。随访3个月,PKP组患者的复发率低于PVP组,差异有统计学意义(P﹤0.05)。结论与PVP联合射频消融术相比,PKP联合射频消融术更能够缓解脊柱转移瘤合并病理性骨折患者的疼痛,改善脊柱稳定性和脊髓神经功能,临床疗效更好,术后复发率更低。

Objective To compare the clinical efficacy of percutaneous vertebroplasty(PVP)and percutaneous ky-phoplasty(PKP)in the treatment of patients with spinal metastasis tumors complicated with pathological fracture.Method According to different treatment methods,86 patients with spinal metastasis tumors complicated with pathologi-cal fracture were divided into PVP group(n=40,PVP combined with radiofrequency ablation)and PKP group(n=46,PKP combined with radiofrequency ablation).The pain degree[visual analogue scale(VAS)],spinal stability,spinal nerve function improvement,clinical efficacy,postoperative complications and recurrence rate were compared between the two groups.Result After surgery,the VAS scores and Cobb angles in both groups were lower than those before surgery,the VAS score and Cobb angle in PKP group were lower than those in PVP group,and the differences were statistically signif-icant(P<0.05).After surgery,the spinal nerve function of PKP group was better than that of PVP group,and the differ-ence was statistically significant(P<0.05).The total effective rate of PKP group was higher than that of PVP group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of postoper-ative complications between the two groups(P>0.05).After 3 months of follow-up,the recurrence rate of PKP group was lower than that of PVP group,and the difference was statistically significant(P<0.05).Conclusion Compared with PVP combined with radiofrequency ablation,PKP combined with radiofrequency ablation can better relieve the pain of pa-tients with spinal metastasis tumors complicated with pathological fracture,improve spinal stability and spinal cord nerve function,and have better clinical efficacy and lower postoperative recurrence rate.