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在骨质疏松性椎体压缩骨折中,双侧经皮椎体后凸成形术与单侧经皮椎体后凸成形术相比,疗效更令人满意:一项综合比较研究。

Bilateral percutaneous kyphoplasty achieves more satisfactory outcomes compared to unilateral percutaneous kyphoplasty in osteoporotic vertebral compression fractures: A comprehensive comparative study.

作者信息

Lu Jianhua, Huang Li, Chen Weikai, Luo Zongping, Yang Huilin, Liu Tao

机构信息

Department of Orthopaedic Surgery, Haimen People's Hospital Affiliated to Nantong University, Nantong, Jiangsu, China.

Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

出版信息

J Back Musculoskelet Rehabil. 2023;36(1):97-105. doi: 10.3233/BMR-210225.

Abstract

BACKGROUND

Osteoporotic vertebral compression fractures (OVCFs) are the most common complication of osteoporosis, a worldwide disease that disturbs the elderly.

OBJECTIVE

The purpose of the study was to comprehensively compare the clinical efficacy of unilateral percutaneous kyphoplasty (UPKP) and bilateral percutaneous kyphoplasty (BPKP) when treating OVCFs and evaluate their ability to maintain the outcomes in a 2-year follow-up.

METHODS

From January 2015 to December 2016 a total of 79 patients with OVCFs were included in the study. They were divided into UPKP group and BPKP group. Subsequently, perioperative data, radiological outcomes, clinical outcomes, and complications were compared between two groups. The follow-up consultation was 3 months, 1 year, and 2 years after the operation.

RESULTS

37 of patients (14 males, 23 females) were allocated to the UPKP group and 42 patients (13 males, 29 females) were treated with BPKP. The duration of operation and injected cement volume were significantly higher in the BPKP group than those of the UPKP group. BPKP achieved significantly higher improvement in middle height and volume of the fractured vertebral body than UPKP did. There were significantly higher losses of anterior, middle height and volume of the fractured vertebral body in the UPKP group at 2-year follow-up than in the BPKP group. At the final follow-up, Oswestry Disability Index (ODI) of BPKP group was lower than that of UPKP group.

CONCLUSION

Both UPKP and BPKP achieve satisfactory radiological and clinical outcomes when treating OVCFs. However, in a 2-year follow-up, BPKP maintains vertebral height restoration, volume of vertebral body, and ODI better than UPKP do.

摘要

背景

骨质疏松性椎体压缩骨折(OVCFs)是骨质疏松症最常见的并发症,骨质疏松症是一种困扰全球老年人的疾病。

目的

本研究旨在全面比较单侧经皮椎体后凸成形术(UPKP)和双侧经皮椎体后凸成形术(BPKP)治疗OVCFs的临床疗效,并评估其在2年随访中维持疗效的能力。

方法

2015年1月至2016年12月,共有79例OVCFs患者纳入本研究。他们被分为UPKP组和BPKP组。随后,比较两组的围手术期数据、影像学结果、临床结果和并发症。术后3个月、1年和2年进行随访咨询。

结果

37例患者(14例男性,23例女性)被分配到UPKP组,42例患者(13例男性,29例女性)接受BPKP治疗。BPKP组的手术时间和骨水泥注入量显著高于UPKP组。BPKP在骨折椎体的中部高度和体积改善方面显著高于UPKP。在2年随访时,UPKP组骨折椎体的前部、中部高度和体积损失显著高于BPKP组。在最终随访时,BPKP组的Oswestry功能障碍指数(ODI)低于UPKP组。

结论

UPKP和BPKP在治疗OVCFs时均取得了满意的影像学和临床效果。然而,在2年随访中,BPKP在维持椎体高度恢复、椎体体积和ODI方面优于UPKP。

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