Department of Orthopedic Surgery, CR & WISCO General Hospital, Wuhan University of Science and Technology, No. 209 Yejin Road, Wuhan, 430000, Hubei Province, People's Republic of China.
Department of Orthopedic Surgery, Emergency General Hospital, Beijing, 100028, People's Republic of China.
BMC Musculoskelet Disord. 2020 Apr 13;21(1):238. doi: 10.1186/s12891-020-03271-9.
Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are widely used in the treatment of Kümmell's disease. The purpose of this article is to investigate the clinical efficacy of PVP and PKP for Kümmell's disease.
The clinical data that 56 cases of Kümmell's disease treated with either PVP (28 cases) or PKP (28 cases) from December 2015 to December 2017 were prospectively analyzed. Gender, age, course of disease, injury segment, bone mineral density (BMD), visual analogue scale (VAS), Oswestry disability index (ODI), imaging measurement indexes before surgery between the two groups showed no significant difference (all P > 0.05). The bone cement leakage rate, bone cement injection amount, operation time, VAS, ODI, the rate of vertebral compression, correction rate of kyphosis and refracture rate of adjacent vertebra in 2 years were compared between the two groups to calculate clinical efficacy.
The two groups were followed up for 24-48 months. There was no significant difference in the follow-up time, amount of bone cement injected, incidence of bone cement leakage and refracture rate of adjacent vertebrae between the two groups (all P > 0.05). The operation time, intraoperative blood loss and fluoroscopy times of the PVP group were significantly lower than those of the PKP group (all P = 0.000). VAS score and ODI of the two groups were significantly lower at 1 day, 1 year and 2 years after surgery than before surgery (all P < 0.05), but there was not statistically significant difference between the two groups at each time point after surgery (all P > 0.05). The rate of vertebral compression and kyphosis correction in the two groups were significantly corrected (P < 0.05, respectively) and decreased significantly with time (all P < 0.05), But there was not significant difference between the two groups at any time point (all P > 0.05).
Both PVP and PKP can achieve similar effects in the treatment of Kümmell's disease. Because the cost, operation time, blood loss, radiation exposure and surgical procedure of PVP are less than those of PKP, PVP has more clinical priority value.
经皮椎体成形术（PVP）和经皮后凸成形术（PKP）广泛用于治疗 Kümmell 病。本文旨在研究 PVP 和 PKP 治疗 Kümmell 病的临床疗效。
前瞻性分析 2015 年 12 月至 2017 年 12 月采用 PVP（28 例）或 PKP（28 例）治疗的 56 例 Kümmell 病患者的临床资料。两组性别、年龄、病程、损伤节段、骨密度（BMD）、视觉模拟量表（VAS）、Oswestry 功能障碍指数（ODI）、术前影像学测量指标比较，差异均无统计学意义（均 P＞0.05）。比较两组患者术后 2 年骨水泥渗漏率、骨水泥注入量、手术时间、VAS、ODI、椎体压缩率、后凸畸形矫正率及邻近椎体再骨折率，计算临床疗效。
两组患者均获随访 24~48 个月。两组患者随访时间、骨水泥注入量、骨水泥渗漏发生率及邻近椎体再骨折率比较，差异均无统计学意义（均 P＞0.05）。PVP 组手术时间、术中出血量、透视次数均明显低于 PKP 组（均 P＝0.000）。两组患者术后 1 天、1 年、2 年 VAS 评分及 ODI 均明显低于术前（均 P＜0.05），但术后各时间点两组间比较，差异均无统计学意义（均 P＞0.05）。两组患者椎体压缩率、后凸畸形矫正率均明显矫正（均 P＜0.05），且随时间推移逐渐降低（均 P＜0.05），但两组各时间点比较，差异均无统计学意义（均 P＞0.05）。
PVP 和 PKP 治疗 Kümmell 病均可取得相似的效果。因 PVP 的费用、手术时间、出血量、辐射暴露及手术操作均少于 PKP，故 PVP 具有更显著的临床优先价值。
