He Lei, Qian Yu, Jin Yi-jun
Zhongguo Gu Shang. 2014 Dec;27(12):1056-61.
To compare clinical outcomes of bilateral transpedicular balloon kyphoplasty for the treatment of ordinary osteoporotic vertebral compressive fracture (OVCF) and severe osteoporotic vertebral compressive fracture.
From Junary 2009 to Febuary 2011, 60 patients (70 vertebrae) with osteoporotic vertebral compressive fracture were included. All patients were treated by bilateral transpedicular balloon kyphoplasty combined with postural reduction, including 10 males and 50 females aged from 59 to 90 years old with an average of 72.1 years old. In ordinary osteoporotic vertebral compressive fracture group, there were 38 patients (44 vertebrae) including 7 males and 31 females aged from 59 to 87 years old with an average of (71.8±6.1) years old. There were 6 patients with two vertebral fractures, 1 vertebra in T9, 5 vertebrae in T10, 7 vertebrae in T11, 13 vertebrae in T12, 9 vertebrae in L1, 4 vertebrae in L2, 4 vertebrae in L3, 1 vertebra in L4. While in severe osteoporotic vertebral compressive fracture group, there were 22 patients (26 vertebrae) including 3 males and 19 females aged from 63 to 90 years old with an average of (72.6±7.2) years old. There were 4 patients with two vertebral fractures, 1 vertebra in T9, 2 vertebrae in T10, 3 vertebrae in T11, 9 vertebrae in T12, 6 vertebrae in L1, 3 vertebrae in L2, 2 vertebrae in L3. Operative time, volume of bone cement injection, and vertebral height and changes of Cobb angle before and after operation were observed and compared. Postoperative average recovery rate of vertebral height and correct degree of Cobb angle were caculated and compared, VAS scoring were used to evaluate therapeutic effect.
All operations were completed sucessfully, and pain were relieved at 72 h after operation. All patients were followed up from 6 to 13 months with an average of 10.1 months. Postoperative vertebral height, Cobb angle and VAS score were improved better than that of before operation (P<0.05). Operative time in ordinary group was shorter than severe group, while volume of bone cement injection was more than that of severe group. Average recovery rate of vertebral height and correct degree of Cobb angle in ordinarty group was better than that of in severe group (P<0.05). There was no significant differences between two groups in VAS scores before and after operation (P> 0.05). Three cases (3 vertebrae) ocurred bone cement leakage in ordinarty group, while 5 cases (5 vertebrae) ocurred bone cement leakage in severe group, and there was no meaning between two groups (P>0.05).
Kyphoplasty could receive satisfied curative effect in treating ordinary and servere patients with osteoporotic vertebral compressive fracture, but recovery of vertebral height and correct degree of Cobb angle in ordinary gourp was better than that of in servere group.
比较双侧经椎弓根球囊椎体后凸成形术治疗普通骨质疏松性椎体压缩骨折（OVCF）与严重骨质疏松性椎体压缩骨折的临床疗效。
纳入2009年1月至2011年2月间60例（70个椎体）骨质疏松性椎体压缩骨折患者。所有患者均接受双侧经椎弓根球囊椎体后凸成形术联合体位复位治疗，其中男性10例，女性50例，年龄59至90岁，平均72.1岁。普通骨质疏松性椎体压缩骨折组38例（44个椎体），男性7例，女性31例，年龄59至87岁，平均（71.8±6.1）岁。有6例患者为双椎体骨折，T9椎体1个，T10椎体5个，T11椎体7个，T12椎体13个，L1椎体9个，L2椎体4个，L3椎体4个，L4椎体1个。而严重骨质疏松性椎体压缩骨折组22例（26个椎体），男性3例，女性19例，年龄63至90岁，平均（72.6±7.2）岁。有4例患者为双椎体骨折，T9椎体1个，T10椎体2个，T11椎体3个，T12椎体9个，L1椎体6个，L2椎体3个，L3椎体2个。观察并比较手术时间、骨水泥注入量以及术前术后椎体高度和Cobb角的变化。计算并比较术后椎体高度平均恢复率及Cobb角矫正度，采用视觉模拟评分法（VAS）评估治疗效果。
所有手术均顺利完成，术后72小时疼痛缓解。所有患者随访6至13个月，平均10.1个月。术后椎体高度、Cobb角及VAS评分均较术前明显改善（P<0.05）。普通组手术时间短于严重组，而骨水泥注入量多于严重组。普通组椎体高度平均恢复率及Cobb角矫正度优于严重组（P<0.05）。两组手术前后VAS评分差异无统计学意义（P>0.05）。普通组发生骨水泥渗漏3例（3个椎体），严重组发生骨水泥渗漏5例（5个椎体），两组差异无统计学意义（P>0.05）。
椎体后凸成形术治疗普通及严重骨质疏松性椎体压缩骨折患者均可获得满意疗效，但普通组椎体高度恢复及Cobb角矫正程度优于严重组。
