Gan Minfeng, Zou Jun, Song Dawei, Zhu Xuesong, Wang Genlin, Yang Huilin
Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China.
Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, PR China
Acta Radiol. 2014 Oct;55(8):985-91. doi: 10.1177/0284185113511603. Epub 2013 Nov 26.
Osteoporotic vertebral biconcave-shaped fractures are not commonly seen in clinical practice. Some articles have been published showing the outcome of vertebroplasty (PV) and balloon kyphoplasty (BKP), but few comparative studies have been performed.
To compare the effect and safety of PV and BKP in treating osteoporotic vertebral biconcave-shaped fractures.
In this retrospective comparative study, 38 patients with osteoporotic vertebral biconcave-shaped fractures were treated by PV, and 41 patients were treated by BKP from May 2005 to July 2011. The heights of the compromised vertebral body and the kyphotic angles were measured. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate pain and functional activity, respectively. The occurrence of refracture and cement leakage were determined, and the costs were recorded.
The mean VAS and ODI scores significantly improved for both procedures at postsurgical measurements (P < 0.05), and the improvement sustained at the final follow-up. In both groups, there were no significant differences in terms of restoration of the anterior vertebral height and correction of the kyphotic deformity. However, BKP was more effective in restoring the middle vertebral height than PV. Cement leakages were observed in nine (23.7%) treated vertebral bodies in PV group and in three (7.4%) treated vertebral bodies in BKP group, which was a statistically significant difference (P < 0.05). There were four new osteoporotic vertebral fractures in the PV group and two in the BKP group during the follow-up period. The mean cost in the BKP group (6200 ± 122.1 USD) was higher than the PV group (2100 ± 112.5 USD) (P < 0.05).
Both PV and BKP achieved similar improvements in pain and functional outcomes for the treatment of osteoporotic vertebral biconcave-shaped fractures. BKP had a significant advantage over PV in terms of the restoration of the middle vertebral height and fewer cement leakages than PV.
骨质疏松性椎体双凹形骨折在临床实践中并不常见。已有一些文章发表了椎体成形术（PV）和球囊扩张椎体后凸成形术（BKP）的治疗结果，但很少有对比研究。
比较PV和BKP治疗骨质疏松性椎体双凹形骨折的疗效和安全性。
在这项回顾性对比研究中，2005年5月至2011年7月期间，38例骨质疏松性椎体双凹形骨折患者接受了PV治疗，41例患者接受了BKP治疗。测量了受损椎体的高度和后凸角。分别采用视觉模拟评分法（VAS）和Oswestry功能障碍指数（ODI）评估疼痛和功能活动。确定再骨折和骨水泥渗漏的发生情况，并记录费用。
两种手术术后测量时VAS和ODI平均评分均显著改善（P < 0.05），且在最终随访时改善持续存在。两组在前椎体高度恢复和后凸畸形矫正方面无显著差异。然而，BKP在恢复椎体中部高度方面比PV更有效。PV组9个（23.7%）治疗椎体出现骨水泥渗漏，BKP组3个（7.4%）治疗椎体出现骨水泥渗漏，差异有统计学意义（P < 0.05）。随访期间，PV组有4例新发骨质疏松性椎体骨折，BKP组有2例。BKP组平均费用（6200 ± 122.1美元）高于PV组（2100 ± 112.5美元）（P < 0.05）。
PV和BKP在治疗骨质疏松性椎体双凹形骨折的疼痛和功能结局方面取得了相似的改善。BKP在恢复椎体中部高度方面比PV有显著优势，且骨水泥渗漏比PV少。
