Liu Zixiang, Li Hanwen, Tang Yingchuang, Liu Hao, Zhang Junxin, Zou Jun, Zhang Kai, Chen Kangwu
Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.
Exp Ther Med. 2023 May 22;26(1):335. doi: 10.3892/etm.2023.12034. eCollection 2023 Jul.
To assess the clinical and radiographic effectiveness of unilateral and bilateral percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (OVCF) associated with scoliosis, 52 patients with OVCF associated with scoliosis who underwent PKP were retrospectively analysed. The patients were divided into the unilateral PKP group (n=26) and the bilateral PKP group (n=26). The operation time, bone cement injection volume and frequency of intraoperative fluoroscopy were recorded and compared between the groups. Additionally, visual analogue scale (VAS) and Oswestry disability index (ODI) scores, as well as postoperative complications, including bone cement leakage and adjacent vertebral fractures, were also assessed. The operation time, bone cement injection volume and intraoperative fluoroscopy frequency were significantly lower in the unilateral compared with the bilateral group (P<0.001). The VAS score, ODI score, average vertebral body height and kyphotic angle (KA) were improved after surgery in each group with no difference in these clinical parameters between the two groups both before and after surgery. Furthermore, the proportion of cases with bone cement leakage in the unilateral group was significantly lower compared with that in the bilateral group (P<0.05). During the follow-up, there were three cases (11.5%) in the unilateral group and two cases (7.7%) in the bilateral group who suffered adjacent vertebral fractures, but there was no statistically significant difference between the two groups (P>0.05). For treating patients with OVCF accompanied by scoliosis, both unilateral and bilateral PKP could effectively relieve the acute back pain and correct the KA. However, unilateral PKP presents more advantages, such as a short operation duration and reduced intraoperative fluoroscopy frequency and bone cement leakage.
为评估单侧和双侧经皮椎体后凸成形术（PKP）治疗与脊柱侧弯相关的骨质疏松性椎体压缩骨折（OVCF）的临床和影像学效果，对52例行PKP治疗的与脊柱侧弯相关的OVCF患者进行回顾性分析。患者分为单侧PKP组（n = 26）和双侧PKP组（n = 26）。记录并比较两组的手术时间、骨水泥注射量和术中透视次数。此外，还评估了视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）评分以及术后并发症，包括骨水泥渗漏和相邻椎体骨折。与双侧组相比，单侧组的手术时间、骨水泥注射量和术中透视次数显著更低（P<0.001）。每组术后VAS评分、ODI评分、平均椎体高度和后凸角（KA）均得到改善，两组手术前后这些临床参数无差异。此外，单侧组骨水泥渗漏病例的比例显著低于双侧组（P<0.05）。随访期间，单侧组有3例（11.5%）、双侧组有2例（7.7%）发生相邻椎体骨折，但两组之间无统计学显著差异（P>0.05）。对于治疗伴有脊柱侧弯的OVCF患者，单侧和双侧PKP均可有效缓解急性背痛并矫正KA。然而，单侧PKP具有更多优势，如手术时间短、术中透视次数减少以及骨水泥渗漏减少。
