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单侧与双侧椎体成形术治疗严重骨质疏松性椎体压缩骨折

Unilateral versus bilateral vertebroplasty for severe osteoporotic vertebral compression fractures.

作者信息

Chen Chunmao, Bian Jian, Zhang Wenjie, Zhang Wei, Zhao Chunming, Wei Haifeng

机构信息

Department of Orthopaedic Surgery, Taizhou People's Hospital, Taizhou, Jiangsu Province, China.

出版信息

J Spinal Disord Tech. 2014 Dec;27(8):E301-4. doi: 10.1097/BSD.0000000000000118.

Abstract

STUDY DESIGN

This was a prospective study of patients who underwent vertebroplasty (VP) at a single institute.

OBJECTIVE

The aim of this study was to assess and compare the clinical outcomes and complications of unilateral and bilateral VP in treating severe vertebral compression fractures.

SUMMARY OF BACKGROUND DATA

Typically, VP involves cement injection by bilateral transpedicular or extrapedicular approach. Recently, several articles reported that unilateral VP can achieve comparable outcomes in most cases. However, few prospective randomized studies compared the clinical outcomes and complications in treating severe vertebral compression fractures.

METHODS

Thirty-nine patients with 44 severe osteoporotic vertebral compression fractures (OVCFs) were randomly allocated into 2 groups adopting unilateral or bilateral VP. Preoperative and postoperative pain scores, back disability, and cement leakage were recorded and compared.

RESULTS

Significant improvement on the visual analog scale and Oswestry disability index scores were noted in each group, and there were no significant differences between the 2 groups. Cement leakage was seen more in bilateral VP.

CONCLUSIONS

Severe OVCFs should be candidates for VP. The unilateral VP can get the same clinical results with fewer complications compared with the bilateral VP.

摘要

研究设计

这是一项对在单一机构接受椎体成形术(VP)的患者进行的前瞻性研究。

目的

本研究的目的是评估和比较单侧和双侧VP治疗严重椎体压缩骨折的临床结果和并发症。

背景数据总结

通常,VP通过双侧椎弓根或椎弓根外途径注入骨水泥。最近,几篇文章报道,在大多数情况下,单侧VP可取得类似的结果。然而,很少有前瞻性随机研究比较治疗严重椎体压缩骨折的临床结果和并发症。

方法

将39例患有44处严重骨质疏松性椎体压缩骨折(OVCF)的患者随机分为两组,分别采用单侧或双侧VP。记录并比较术前和术后的疼痛评分、背部功能障碍和骨水泥渗漏情况。

结果

两组患者的视觉模拟量表和Oswestry功能障碍指数评分均有显著改善,两组之间无显著差异。双侧VP中骨水泥渗漏更为常见。

结论

严重OVCF患者应考虑行VP。与双侧VP相比,单侧VP可获得相同的临床效果,且并发症更少。

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