椎体成形与网袋成形治疗骨质疏松性骨折早期效果比较

Comparison of early outcomes between percutaneous vertebroplasty and vesselplasty for osteoporotic compression fracture

[目的]比较网袋球囊椎体成形和椎体成形(PVP)治疗胸腰椎骨质疏松性骨折(OVCF)的效果、技术特点及并发症等。[方法]回顾性分析2014～2017年同一术者治疗的胸腰椎骨质疏松性骨折患者74例,其中PVP治疗58例(62个椎体),平均年龄(75.11±9.96)岁;网袋成形治疗16例(17个椎体),平均年龄(74.71±7.67)岁。比较两种方法的技术特点、椎体复高率、疼痛缓解满意程度、住院时间、操作时间、并发症等。[结果]手术时间PVP组平均(53.20±14.54) min,网袋成形组平均(61.17±11.93) min,两组间差异无统计学意义(P>0.05);两组均无有临床症状的并发症发生,PVP组骨水泥泄漏发生率11.29%,网袋成形组11.76%,差异无统计学意义(P>0.05)。术后椎体高度恢复率PVP组(25.31±24.33)%,网袋成形组(26.78±22.30)%,差异无统计学意义(P>0.05)。两组术后第3 d腰痛VAS评分均较术前显著下降(P<0.05),但相同时间点二组间差异无统计学意义(P>0.05)。[结论]网袋成形作为新近出现的一种椎体成形技术,实际应用中临床疗效、骨水泥泄漏的发生率、患者住院时间、椎体复高率等指标与传统PVP相比没有显著优势。

[Objective]To compare the early outcomes of percutaneous vertebroplasty(PVP)versus vesselplasty for osteoporotic compression fracture.[Methods]A retrospective study was conducted on 74 patients who underwent surgical treatment by the same surgeon between 2014 and 2017.Of them,58 patients(62 vertebrae)aged(75.11±9.96)years received PVP,while 16patients(17 vertebrae)aged(74.71±7.67)years had vesselplasty.The operation time,hospital stay,complications,visual analogue scale(VAS)and radiographic measurement,such as vertebral body height,were compared between the two groups.[Results]The PVP group consumed less operation time than the vesselplasty group although no a statistically significant difference was proved between them[(53.20±14.54)min versus(61.17±11.93)min,P>0.05].Despite of the fact that no symptomatic complication happened in any patient of both groups,the bone cement leakage occurred 11.29%in the PVP group,whereas 11.76%in the vesselplasty group without a statistically significant difference between them(P>0.05).After operation,the PVP group got recovery rate of(25.31±24.33)%,whereas the vesselplasty group had the recovery rate of(26.78±22.30)%regarding to vertebral body height,with no a statistical difference between them(P>0.05).The VAS in both groups significantly decreased at 3days postoperatively compared with that preoperatively(P<0.06),although no statistically significant differences were proved between the two groups at any corresponding time point(P>0.05).[Conclusion]The vesselplasty,a novel technique,does not show any significant benefits in early clinical outcomes,such as operation time,incidence of bone cement leakage,hospital stay and recovery rate of vertebral body height,over the conventional PVP.