Orthopedics Department, The Second Affiliated Hospital of Nanjing Medical University, Jiangjiayuan Road No. 121, Nanjing, 210000, Jiangsu Province, China.
BMC Surg. 2021 May 21;21(1):252. doi: 10.1186/s12893-021-01246-8.
A few reports have shown that unilateral transverse process-pedicle percutaneous kyphoplasty is a good choice for patients with osteoporotic vertebral compression fracture (OVCF). However, this issue remains controversial and the related comprehensive research was lacked.
A retrospective study was conducted on patients receiving PKP surgery for OVCF. Patients were divided into three groups according to surgical approach. Symptom and radiographical evaluation were performed preoperatively, 1-month postoperatively, 1-year postoperatively and follow-ups. And follow-ups were repeated every year. Visual Analogue Scale Score (VAS), Oswestry Disability Index (ODI) scores, anterior vertebral height, coronal Cobb angle and sagittal Cobb angle was determined and compared among three groups.
Totally 447 patients were included with an average age of 76.6 ± 7.2 years old. UTP showed significantly shorter surgical duration (p < 0.001), lower cement volume (p < 0.001) but higher cement leakage proportion (p = 0.044). No significant statistical difference was found in terms of improvement rates among three groups. Besides, it was notable that the a significantly higher coronal Cobb angle was observed in UTP group, and a about 4°coronal correction was found after UTP PKP.
UTTP PKP could achieve similar symptoms relief and kyphosis correction as UTP and BTP PKP. However, it had shorter surgical time and less radio exposure than BTP PKP, lower risk of cement leakage and higher proportion of bilaterally cement distribution than UTP PKP. It seemed to be a better choice for patients with OVCF. In addition, we found that UTP PKP was especially fit for OVCF patients with asymmetrical vertebral compression.
有一些报道表明，单侧经横突-椎弓根经皮椎体后凸成形术（PKP）是治疗骨质疏松性椎体压缩性骨折（OVCF）患者的一种较好的选择。然而，这个问题仍存在争议，相关的综合研究也较为缺乏。
对接受 OVCF 经皮 PKP 手术的患者进行回顾性研究。根据手术入路将患者分为三组。分别在术前、术后 1 个月、术后 1 年及随访时进行症状和影像学评估。并每年进行一次随访。比较三组患者的视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）评分、椎体前缘高度、冠状位 Cobb 角和矢状位 Cobb 角。
共纳入 447 例患者，平均年龄为 76.6±7.2 岁。UTP 组的手术时间明显更短（p<0.001），骨水泥用量明显更少（p<0.001），但骨水泥渗漏比例更高（p=0.044）。三组间改善率无统计学差异。此外，UTP 组的冠状位 Cobb 角明显较高，UTP PKP 后冠状位矫正约为 4°。
UTTPKP 可达到与 UTP 和 BTP PKP 相似的缓解症状和矫正后凸畸形的效果。然而，与 BTP PKP 相比，UTTPKP 具有手术时间更短、放射暴露更少、骨水泥渗漏风险更低、双侧骨水泥分布比例更高的优势。对于 OVCF 患者来说，UTTPKP 似乎是一种更好的选择。此外，我们发现 UTP PKP 尤其适用于椎体压缩不对称的 OVCF 患者。
