Jiang Jiawei, Zhang Jinlong, Bao Guofeng, Chen Jiajia, Wu Chunshuai, Hong Hongxiang, Xue Pengfei, Xu Guanhua, Cui Zhiming
Department of Spine Surgery, The Affiliated 2 Hospital of Nantong University, Nantong, China.
Front Surg. 2022 Oct 19;9:1010042. doi: 10.3389/fsurg.2022.1010042. eCollection 2022.
To compare the clinical outcomes and radiological parameters of patients undergoing percutaneous vertebroplasty (PVP) versus those undergoing percutaneous vertebral-disc plasty (PVDP) for back pain, segmental instability, and kyphosis due to thoracolumbar very severe osteoporotic vertebral compression fractures (vsOVCFs).
This prospective randomized controlled study included elderly patients with thoracolumbar vsOVCFs. All the patients were randomly allocated into the PVP group (who underwent conventional PVP) and the PVDP group (who underwent PVP combined percutaneous cement discoplasty). The visual analogue scale (VAS), Oswestry Disability Index (ODI), local kyphosis angle, and disc height were recorded preoperatively and postoperatively.
Significant postoperative improvements in the VAS, ODI, and the local kyphosis angle (LKA) were shown, compared with the preoperative values in both groups ( < 0.05). The average VAS, ODI, and LKA for patients in the PVP group were increased compared to those in the PVDP group observed at the last follow-up ( < 0.05). The DHA, DHP, and LKA were seen to be maintained in the PVDP group at the last follow-up ( > 0.05). The change was significantly lower in the PVDP group at the last follow-up in those parameters ( < 0.05).
PVDP may be a feasible and effective technique for the treatment of very severe OVCFs, that can restore intervertebral height, provide segmental stabilizing and relieve back pain in the short term.
比较因胸腰椎极重度骨质疏松性椎体压缩骨折(vsOVCFs)导致背痛、节段性不稳和后凸畸形的患者接受经皮椎体成形术(PVP)与经皮椎间盘成形术(PVDP)后的临床疗效和影像学参数。
这项前瞻性随机对照研究纳入了患有胸腰椎vsOVCFs的老年患者。所有患者被随机分为PVP组(接受传统PVP)和PVDP组(接受PVP联合经皮水泥椎间盘成形术)。术前和术后记录视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、局部后凸角和椎间盘高度。
与两组术前值相比,术后VAS、ODI和局部后凸角(LKA)均有显著改善(<0.05)。在最后一次随访时,PVP组患者的平均VAS、ODI和LKA相较于PVDP组有所增加(<0.05)。在最后一次随访时,PVDP组的椎间盘高度(DHA)、椎间盘厚度(DHP)和LKA得以维持(>0.05)。在最后一次随访时,PVDP组这些参数的变化显著更低(<0.05)。
PVDP可能是一种治疗极重度OVCFs的可行且有效的技术,它可以恢复椎间高度,提供节段性稳定并在短期内缓解背痛。