Hospital for Special Surgery, 535 East 70th Street, New York, New York 10021, USA.
Bone Joint J. 2013 Mar;95-B(3):401-6. doi: 10.1302/0301-620X.95B3.29819.
This is a prospective randomised study comparing the clinical and radiological outcomes of uni- and bipedicular balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. A total of 44 patients were randomised to undergo either uni- or bipedicular balloon kyphoplasty. Self-reported clinical assessment using the Oswestry Disability Index, the Roland-Morris Disability questionnaire and a visual analogue score for pain was undertaken pre-operatively, and at three and twelve months post-operatively. The vertebral height and kyphotic angle were measured from pre- and post-operative radiographs. Total operating time and the incidence of cement leakage was recorded for each group. Both uni- and bipedicular kyphoplasty groups showed significant within-group improvements in all clinical outcomes at three months and twelve months after surgery. However, there were no significant differences between the groups in all clinical and radiological outcomes. Operating time was longer in the bipedicular group (p < 0.001). The incidence of cement leakage was not significantly different in the two groups (p = 0.09). A unipedicular technique yielded similar clinical and radiological outcomes as bipedicular balloon kyphoplasty, while reducing the length of the operation. We therefore encourage the use of a unipedicular approach as the preferred surgical technique for the treatment of osteoporotic vertebral compression fractures.
这是一项前瞻性随机研究，比较了单双侧球囊扩张椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床和影像学结果。共有 44 名患者被随机分为单双侧球囊扩张椎体后凸成形术组。术前及术后 3 个月和 12 个月采用 Oswestry 功能障碍指数、Roland-Morris 残疾问卷和疼痛视觉模拟评分进行自我报告的临床评估。从术前和术后 X 线片测量椎体高度和后凸角。记录每组的总手术时间和骨水泥渗漏的发生率。单双侧球囊扩张椎体后凸成形术组在术后 3 个月和 12 个月所有临床结局均有显著的组内改善。然而，两组在所有临床和影像学结局方面均无显著差异。双侧组的手术时间更长（p<0.001）。两组骨水泥渗漏的发生率无显著差异（p=0.09）。单侧技术的临床和影像学结果与双侧球囊扩张椎体后凸成形术相似，但手术时间更短。因此，我们鼓励使用单侧入路作为骨质疏松性椎体压缩骨折的首选手术治疗方法。
