Zhou Xiaoshu, Meng Xiaotong, Zhu Haitao, Zhu Yue, Yuan Wei
Department of Orthopedics, First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, China.
Department of Orthopedics, First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, China.
Clin Neurol Neurosurg. 2019 May;180:101-105. doi: 10.1016/j.clineuro.2019.03.029. Epub 2019 Apr 1.
Osteoporotic vertebral compression fracture (OVCF) is a common disease in the aged population that can greatly affect the quality of life. Percutaneous kyphoplasty (PKP) has become a mainstream approach for treating OVCF, but the optimal surgical timing for treating OVCF with PKP remains controversial. In the current study, we retrospectively studied patients with OVCF that underwent PKP, and aimed to find out whether surgical timing could affect the clinical and radiological outcomes.
We retrospectively studied 62 patients who underwent PKP for OVCF. Patients were divided into 2 groups based on the timing of PKP: operation within 4 weeks (group A) and operation later than 4 weeks (group B). VAS, ODI, height of fracture vertebra, restored height rate, local kyphosis angle and complications were assessed preoperatively and throughout the follow-up.
There were 36 cases (58 fracture vertebra) in the group A and 26 cases (40 fracture vertebra) in the group B. There was no significant difference between the two groups regarding to the demographic data before surgery. In terms of the VAS and ODI, no statistical difference was observed before operation, after operation and at the 6th month follow-up between the two groups. The HRR after operation and at the 6 month follow-up in the group A was 17.5 ± 5.3% and 10.5 ± 3.7%, and that in the group B was 7.2 ± 3.2% and 3.6 ± 1.1%, and there is significant difference between the two groups (p < 0.05). The LKA (preoperatively / post-operatively / 6th month follow-up) was -12.7°, -7.3°, -11.4° in the group A and -17.6°, -14.4°, -16.1° in the group B. There was significant difference between the two groups at all the time points for local kyphosis angle (p < 0.01), with a lower rate of subsequent vertebral fracture in the group A (p < 0.05).
Both surgical timings of PKP showed similar outcomes in terms of the VAS and ODI. Early PKP could result in better restoration of vertebral body height and reduced rate of subsequent fracture compared to late PKP.
骨质疏松性椎体压缩骨折（OVCF）是老年人群中的常见疾病，会严重影响生活质量。经皮椎体后凸成形术（PKP）已成为治疗OVCF的主流方法，但PKP治疗OVCF的最佳手术时机仍存在争议。在本研究中，我们回顾性研究了接受PKP治疗的OVCF患者，旨在确定手术时机是否会影响临床和影像学结果。
我们回顾性研究了62例接受PKP治疗OVCF的患者。根据PKP手术时机将患者分为2组：4周内手术（A组）和4周后手术（B组）。术前及整个随访过程中评估视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、骨折椎体高度、椎体高度恢复率、局部后凸角及并发症。
A组36例（58个骨折椎体），B组26例（40个骨折椎体）。两组术前人口统计学数据无显著差异。在VAS和ODI方面，两组术前、术后及术后6个月随访时均无统计学差异。A组术后及术后6个月随访时的椎体高度恢复率分别为17.5±5.3%和10.5±3.7%，B组分别为7.2±3.2%和3.6±1.1%，两组间有显著差异（p<0.05）。A组局部后凸角（术前/术后/术后6个月随访）分别为-12.7°、-7.3°、-11.4°，B组分别为-17.6°、-14.4°、-16.1°。两组在所有时间点的局部后凸角均有显著差异（p<0.01），A组后续椎体骨折发生率较低（p<0.05）。
PKP的两种手术时机在VAS和ODI方面显示出相似的结果。与晚期PKP相比，早期PKP能更好地恢复椎体高度并降低后续骨折发生率。
