Department of Orthopedics, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang, China (mainland).
Department of Invasive Technology, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang, China (mainland).
Med Sci Monit. 2020 Aug 16;26:e923619. doi: 10.12659/MSM.923619.
BACKGROUND Osteoporotic vertebral compression fracture (OVCF) is a common fracture in the elderly. Conservative treatment requires prolonged bedding, which may lead to serious complications. To explore optimized use of percutaneous kyphoplasty (PKP) in the treatment of senile osteoporotic thoracolumbar vertebral compression fractures, in this study, we used C-arm-guided and double-arm digital subtraction angiography (DSA)-guided PKP to treat OVCF in elderly patients and analyzed the effective recovery. MATERIAL AND METHODS In all, 60 patients who presented with osteoporotic vertebral compression fractures at our hospital between July 2017 and February 2019 were analyzed. They were randomly divided into C-arm-guided group and the double-arm DSA-guided groups. Both groups were treated with percutaneous kyphoplasty. RESULTS A pain VAS score analysis revealed that there was no significant difference between the two groups before surgery (P>0.05). After surgery, the VAS scores showed a significant difference between the C-arm-guided group and the double-arm DSA-guided PKP treatment group (P<0.01). Moreover, with respect to the bone cement dosage, vertebral correction height, operation time, cumulative radiation dose, percolation rate, and volume of bone cement, the double-arm DSA-guided PKP treatment showed significantly better results than the C-arm-guided PKP treatment (P<0.01). CONCLUSIONS Our data revealed that double-arm DSA-guided PKP was more accurate in treatment of senile osteoporotic thoracolumbar vertebral compression fractures, producing excellent performance with more accurate intraoperative evaluation, shorter operative time, lower incidence of bone cement leakage, less intraoperative radiation dose, and higher safety, and thus, could be extensively applied to clinical surgery.
骨质疏松性椎体压缩骨折（OVCF）是老年人常见的骨折。保守治疗需要长时间卧床，可能会导致严重的并发症。为了探讨经皮椎体后凸成形术（PKP）在治疗老年骨质疏松性胸腰椎压缩性骨折中的优化应用，本研究采用 C 臂引导和双臂数字减影血管造影（DSA）引导 PKP 治疗老年 OVCF，并分析了有效恢复情况。
回顾性分析 2017 年 7 月至 2019 年 2 月我院收治的骨质疏松性椎体压缩性骨折患者 60 例，随机分为 C 臂引导组和双臂 DSA 引导组，两组均采用经皮椎体后凸成形术治疗。
疼痛视觉模拟评分分析显示，两组手术前差异无统计学意义（P>0.05）。术后 VAS 评分显示，C 臂引导组与双臂 DSA 引导 PKP 治疗组差异有统计学意义（P<0.01）。另外，在骨水泥剂量、椎体矫正高度、手术时间、累积辐射剂量、渗漏率和骨水泥体积方面，双臂 DSA 引导 PKP 治疗明显优于 C 臂引导 PKP 治疗（P<0.01）。
双臂 DSA 引导 PKP 在治疗老年骨质疏松性胸腰椎压缩性骨折方面更准确，术中评估更准确，手术时间更短，骨水泥渗漏发生率更低，术中辐射剂量更低，安全性更高，因此可广泛应用于临床手术。
