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经皮椎体后凸成形术治疗不同骨密度的椎体压缩性骨折的疗效:一项回顾性研究。

Efficacy of percutaneous kyphoplasty on vertebral compression fractures with different bone mineral densities: a retrospective study.

机构信息

Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 999, Xiwang road, Jiading district, Shanghai, 201801, China.

出版信息

BMC Musculoskelet Disord. 2023 Apr 10;24(1):276. doi: 10.1186/s12891-023-06341-w.

Abstract

BACKGROUND

This study was performed to investigate the clinical efficacy of percutaneous kyphoplasty (PKP) for vertebral compression fractures with different bone mineral densities (BMD).

METHODS

We performed a retrospective analysis of 232 patients with single-segment vertebral compression fractures who underwent PKP. Patients were divided into the normal BMD, osteopenia, and osteoporosis groups according to their average lumbar BMD before surgery. The visual analog scale (VAS) was used to compare differences in pain relief before and after surgery in each group. Corrections of the wedge angle and kyphotic angle before and after surgery were observed using anteroposterior and lateral radiographs and compared among the groups, as was the incidence of bone cement leakage.

RESULTS

Patients were followed up for 6-12 months, with an average follow-up time of 9.12 ± 1.68 months. The VAS score, wedge angle, and kyphotic angle of the three groups of patients decreased significantly at the end of the follow-up (P < 0.05). The changes in VAS score and wedge angle correction in the osteoporosis group were significantly larger than those in the normal BMD and osteopenia groups (P < 0.05). There were no significant differences among the three groups in terms of kyphotic angle correction or bone cement leakage rates (P > 0.05).

CONCLUSIONS

PKP has a positive effect on vertebral compression fractures with different BMD, and is especially suitable for osteoporotic vertebral compression fractures.

摘要

背景

本研究旨在探讨经皮椎体后凸成形术(PKP)治疗不同骨密度(BMD)的椎体压缩骨折的临床疗效。

方法

回顾性分析了 232 例单节段椎体压缩骨折患者行 PKP 的资料。根据术前平均腰椎 BMD 将患者分为正常 BMD、骨量减少和骨质疏松组。采用视觉模拟评分(VAS)比较各组患者术前、术后疼痛缓解的差异。通过前后位和侧位 X 线片观察并比较各组术前、术后楔角和后凸角的矫正情况,以及骨水泥渗漏的发生率。

结果

患者随访 6-12 个月,平均随访时间为 9.12±1.68 个月。三组患者的 VAS 评分、楔角和后凸角在随访结束时均显著降低(P<0.05)。骨质疏松组 VAS 评分和楔角矫正的变化明显大于正常 BMD 和骨量减少组(P<0.05)。三组患者的后凸角矫正或骨水泥渗漏率无显著差异(P>0.05)。

结论

PKP 对不同 BMD 的椎体压缩骨折有积极的治疗作用,尤其适用于骨质疏松性椎体压缩骨折。

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