Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University Xi'an, Shaanxi, China.
Orthopedic Research Institute, Department of Orthopedics, Sichuan University West China Hospital, Chengdu, Sichuan Province, People's Republic of China.
Pain Physician. 2023 Mar;26(2):175-185.
Studies have found that the rate of improvement in pain after percutaneous kyphoplasty (PKP) is 49% to 90%, and there are still some patients who may continue to sustain intractable back pain after surgery.
To compare the clinical efficacy and imaging results between unilateral PKP performed from the symptom-dominating side and the non-dominating side in OVCF treatment.
Prospective study.
All data were from Honghui Hospital in Xi'an.
One hundred forty-two patients of osteoporotic vertebral compression fracture (OVCF) treated with unilateral PKP were eventually recruited and randomly assigned to either the A or B group. Patients in group A received PKP from the symptom-dominating side; patients in group B received PKP from the symptom non-dominating side. The demographic characteristics, related surgical information, and complications observed within both groups were recorded. The clinical outcomes evaluation included the visual analog scale (VAS) score for low back pain and the Oswestry Disability Index (ODI). Evaluation of imaging results included anterior height (AH), kyphosis angulation (KA), and contralateral distribution rate of bone cement.
One hundred eighteen patients (48 men and 70 women; age range: 60-83 years), including 59 patients in the A group and 59 patients in the B group, were available for the complete assessment. There were 5 cases and 7 cases of bone cement leakage in groups A and B, respectively, which were asymptomatic para-vertebral or inter-vertebral leakage without intra-spinal leakage. Compared with the preoperative data, significant improvements in the VAS scores and ODI were observed at each follow-up interval. The VAS score and ODI in the A group were significantly lower than in the B group only within 2 months (P < 0.05). Compared with the preoperative data, the AH and KA in the 2 groups were improved (P < 0.05). There was no significant difference in AH and KA between the 2 groups at each follow-up interval (P > 0.05).
A single-center study.
The unilateral PKP performed via the symptom-dominating side can effectively relieve back pain and improve the patient's quality of life at the early stage.
研究发现经皮椎体后凸成形术（PKP）后疼痛改善率为 49%~90%，仍有部分患者术后持续存在难以忍受的背痛。
比较单侧 PKP 术式从优势侧和非优势侧入路治疗 OVCF 的临床疗效和影像学结果。
前瞻性研究。
所有数据均来自西安红会医院。
最终纳入 142 例骨质疏松性椎体压缩骨折（OVCF）患者，均行单侧 PKP 治疗，随机分为 A 组和 B 组。A 组患者接受优势侧 PKP；B 组患者接受非优势侧 PKP。记录两组患者的一般资料、相关手术信息及并发症。临床疗效评估包括腰痛视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI）。影像学结果评估包括椎体前缘高度（AH）、后凸角（KA）和骨水泥的对侧分布率。
108 例患者（48 例男性，70 例女性；年龄 60~83 岁）完成了完整评估，其中 A 组 59 例，B 组 59 例。A 组和 B 组分别有 5 例和 7 例发生骨水泥渗漏，均为无椎管内渗漏的无症状椎旁或椎间渗漏。与术前相比，两组患者在各随访时间点的 VAS 评分和 ODI 均显著改善。A 组患者的 VAS 评分和 ODI 在术后 2 个月内明显低于 B 组（P < 0.05）。与术前相比，两组患者的 AH 和 KA 在术后均得到改善（P < 0.05）。两组患者在各随访时间点的 AH 和 KA 差异均无统计学意义（P > 0.05）。
单中心研究。
单侧 PKP 从优势侧入路可在早期有效缓解腰痛，提高患者生活质量。
