PKP与PVP治疗骨质疏松性胸腰椎压缩性骨折疗效对比

Comparison of Clinical Efficacy of PKP and PVP in the Treatment of Osteoporotic Thoracolumbar Compression Fracture

目的对比分析经皮椎体后凸成形术(PKP)与经皮椎体成形术(PVP)治疗骨质疏松性胸腰椎压缩性骨折的临床效果。方法选取2020年6月至2022年6月河南科技大学第二附属医院收治的84例骨质疏松性胸腰椎压缩性骨折患者作为研究对象,根据不同治疗方法将其分为PKP组(42例)与PVP组(42例),PKP组患者接受PKP治疗,PVP组患者接受PVP治疗,对比观察两组患者围手术期相关指标、疼痛情况、椎体结构及功能。结果PKP组患者手术时间明显长于PVP组、医疗费用明显多于PVP组(t=2.837、8.176,P=0.006、P<0.001),骨水泥用量、住院时间与PVP组无明显差异(t=0.572、0.389,P=0.569、0.698);术后7 d及术后3个月,PKP组患者视觉模拟评分法(VAS)评分、改良Oswestry功能障碍指数(ODI)评分与PVP组无明显差异(术后7 d:t=1.449、0.761,P=0.151、0.449;术后3个月:t=0.407、1.537,P=0.685、0.128),而椎体前缘高度明显高于PVP组、Cobb角明显小于PVP组(术后7 d:t=3.305、2.873,P=0.001、0.005;术后3个月:t=3.054、4.367,P=0.003、P<0.001)。结论PKP与PVP均能有效减轻骨质疏松性胸腰椎压缩性骨折患者疼痛程度,改善患者椎体功能,但PVP操作更简单、价格更低廉,PKP更有利于纠正患者脊柱后凸畸形,恢复脊柱解剖结构。

Objective To compare the clinical efficacy of percutaneous kyphoplasty(PKP)and percutaneous vertebroplasty(PVP)in the treatment of osteoporotic thoracolumbar compression fracture.Methods 84 patients with osteoporotic thoracolumbar compression fracture,admitted to The Second Affiliated Hospital of Henan University of Science and Technology from June 2020 to June 2022,were enrolled as research subjects and were divided into PKP group(n=42)and PVP group(n=42)based on the different treatments they received.Patients in the PKP group were treated with PKP,whereas patients in the PVP group were treated with PVP.The perioperative indicators,pain degree,vertebral structure and function of patients were compared between the two groups.Results The operation time was significantly longer and the treatment cost was markedly higher in the PKP group compared with the PVP group(t=2.837 and 8.176,P=0.006,P<0.001).There was no significant difference in bone cement volume and the length of stay between the two groups(t=0.572 and 0.389,P=0.569 and 0.698).Respectively at seven days and three months after surgery,no significant difference was observed between the two groups in terms of visual analogue scale(VAS)scores and modified Oswestry disability index(ODI)scores(7 days postoperatively:t=1.449 and 0.761,P=0.151 and 0.449;3 months postoperatively:t=0.407 and 1.537,P=0.685 and 0.128).However,the anterior vertebral body height in the PKP group was significantly higher than that in the PVP group,and the Cobb angle in the PKP group was significantly smaller than that in the PVP group(7 days postoperatively:t=3.305 and 2.873,P=0.001 and 0.005;3 months postoperatively:t=3.054 and 4.367,P=0.003,P<0.001).Conclusion Both PKP and PVP can effectively alleviate pain and improve vertebral function of patients with osteoporotic thoracolumbar compression fracture.However,PVP is much easier⁃to⁃operate and more cost⁃effective,while PKP is more beneficial in correcting patients’spinal kyphosis deformity and restoring spinal anatomical structure.