经皮椎体成形术与经皮后凸成形术治疗骨质疏松性脊柱不对称压缩性骨折的疗效比较。

Comparison of Efficacy of Percutaneous Vertebroplasty versus Percutaneous Kyphoplasty in the Treatment of Osteoporotic Vertebral Asymmetric Compression Fracture.

机构信息

Department of Orthopedic Surgery, the First Affiliated Hospital of Soochow University, Soochow University, Suzhou, Jiangsu, China.

Department of Orthopedic Surgery, the Second People's Hospital of Lianyungang, Lianyungang, Jiangsu, China.

出版信息

World Neurosurg. 2022 Nov;167:e1225-e1230. doi: 10.1016/j.wneu.2022.09.017. Epub 2022 Sep 8.

DOI:10.1016/j.wneu.2022.09.017

PMID:36089275

Abstract

BACKGROUND

This study aims to compare the clinical efficacy of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral asymmetric compression fracture (OVACF).

METHODS

This study retrospectively reviewed the patients who were diagnosed with OVACF between September 2015 and July 2019. Forty-one patients received PVP surgery (group A), and 44 patients received PKP surgery (group B). The visual analog scale, Oswestry Disability Index, scoliosis angle (SA), height of long side, height of short side (HS), and lateral height difference (LHD) before operation and 3 days and 1 year after operation were compared between both groups. The operation time, fluoroscopic time, hospital stay, cement volume, and complications were also compared between both groups.

RESULTS

The visual analog scale and Oswestry Disability Index differed significantly between the groups 1 year after operation (P < 0.05). Compared with the preoperative results, there were significant differences in SA, height of long side, HS, and LHD 3 days and 1 year after operation (P < 0.05). Compared with group A, group B showed significantly better in SA, HS, and LHD in group B 3 days and 1 year after operation (P < 0.05). More patients in group A suffered cement leakage and scoliosis than group B after operation (P < 0.05).

CONCLUSIONS

In our study, PVP and PKP are both effective in the treatment of OVACF, but PKP surgery had better long-term clinical efficacy.

摘要

背景

本研究旨在比较经皮椎体成形术（PVP）和经皮后凸成形术（PKP）治疗骨质疏松性椎体不对称压缩性骨折（OVACF）的临床疗效。

方法

本研究回顾性分析了 2015 年 9 月至 2019 年 7 月期间诊断为 OVACF 的患者。41 例患者接受 PVP 手术（A 组），44 例患者接受 PKP 手术（B 组）。比较两组患者手术前后（术前、术后 3 天、术后 1 年）的视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）、脊柱侧凸角（SA）、长侧高度、短侧高度（HS）、侧方高度差（LHD），并比较两组患者的手术时间、透视时间、住院时间、骨水泥量及并发症。

结果

术后 1 年时两组 VAS 和 ODI 差异有统计学意义（P<0.05）。与术前结果相比，两组患者术后 3 天和 1 年时的 SA、长侧高度、HS 和 LHD 均有显著差异（P<0.05）。与 A 组相比，B 组术后 3 天和 1 年时的 SA、HS 和 LHD 改善更明显（P<0.05）。术后 A 组患者的骨水泥渗漏和脊柱侧凸发生率高于 B 组（P<0.05）。