单侧与双侧PKP治疗骨质疏松性胸腰椎压缩性骨折疗效比较

Comparison of Clinical Effects Between Unilateral and Bilateral PKP for Osteoporotic Thoracolumbar Compression Fractures

目的:对比单侧与双侧经皮椎体后凸成形术(PKP)治疗骨质疏松性胸腰椎压缩性骨折的临床疗效。方法:回顾性分析2011年3月~2014年2月我科采用PKP治疗的60例胸腰椎压缩性骨折患者的临床资料,其中单侧28例,双侧32例。观察两组患者手术时间、X线透视次数、骨水泥注入量及并发症发生情况,并观察视觉模拟疼痛评分(VAS)、椎体Cobb角及椎体平均高度改善情况。结果:两组患者术后VAS评分、椎体Cobb角及椎体平均高度较术前均明显改善,差异有统计学意义(P<0.05),两组间比较差异无统计学意义(P>0.05),单侧组手术时间、X线透视次数及骨水泥用量均显著少于双侧组(P<0.05);单侧组骨水泥渗漏发生率为14.3%,双侧组为28.1%,差异有统计学意义(P<0.05)。结论:单侧与双侧PKP治疗骨质疏松性胸腰椎压缩性骨折均能取得良好的临床疗效,但单侧PKP具有手术时间短、X线暴露少、骨水泥渗漏发生率低等优点。

Objective To compare the clinical effect of unilateral and bilateral Percutaneous kyphoplasty for osteoporotic thoracolumbar compression fractures. Methods 60 cases with osteoporotic vertebral compression fracture and underwent Percutaneous Kyphoplasty from March 2011 to February 2014 were reviewed retrospectively. 28cases were performed by PKP through unipedicular approach and 32 cases through bipedicular approach. Operative time,frequency of X-ray,injection rate of bone cement and complication were observed and Visual Analogue Scale( VAS),average vertebral body height and Cobb's angle were measured pre-and postoperation. Results The Visual Analogue Scale( VAS),average vertebral height and Cobb's angle were statistically improved in both groups after operation( P < 0. 05),but there were no statistical differences in two groups( P > 0. 05). The operative time,X-ray exposure time,volume of bone cement and the incidence of bone cement leakage in unilateral group were much less than that of bilateral group,and it had statistical difference( P < 0. 05). Conclusion Both unilateral and bilateral Percutaneous kyphoplasty are effective for the treatment of osteoporotic thoracolumbar compression fractures,but the former can shorten operation time,reduce X- ray exposure time,and decrease the incidence of bone cement leakage.