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经皮椎体成形术与经皮后凸成形术治疗伴后凸畸形的骨质疏松性椎体压缩骨折的临床疗效比较

Clinical efficacy of percutaneous vertebroplasty versus percutaneous kyphoplasty treating osteoporotic vertebral compression fractures with kyphosis.

作者信息

Liang Dawei, Pei Jia, Pei Ruoyan, Zhou Xianwei, Zhang Xiaohui

机构信息

Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), 100 Yongping Road, Zhengzhou, 450000, Henan, China.

Shenyang Pharmaceutical University, Shenyang, 110000, Liaoning, China.

出版信息

Eur J Trauma Emerg Surg. 2024 Jun;50(3):1043-1049. doi: 10.1007/s00068-023-02416-4. Epub 2023 Dec 19.

Abstract

PURPOSE

This study aimed to investigate the clinical efficacy of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fractures (OVCFs) with kyphosis.

METHODS

The clinical data included 63 patients in the PVP group and 70 in the PKP group. The study assessed the pain visual analog scale (VAS), Oswestry Disability Index (ODI), wedge angle (WA), local kyphotic angle (LKA), and vertebral height.

RESULTS

The operative time was significantly less in the PVP group (p < 0.05). Meanwhile, more bone cement was injected into the PKP group (p < 0.05), with significantly higher surgical costs (p > 0.05). Post-operative VAS, ODI, WA, LKA, and vertebral height were significantly improved in PVP and PKP groups compared with pre-operative measurements (p < 0.05). The results revealed insignificant VAS and ODI improvement differences between the two groups at each follow-up time (p > 0.05). Vertebral height, WA, and LKA improved more significantly in the PKP group at day 1 and 3 months post-operatively (p < 0.05), with insignificant group differences at subsequent time points (p > 0.05). The improvements in VAS were unrelated to those in WA, LKA, or vertebral height in either group (p > 0.05). The improvement in VAS was unrelated to the amount of bone cement injected (p > 0.05); the PKP group demonstrated a lower incidence of cement leakage (12.9%; p < 0.05).

CONCLUSION

PVP and PKP can restore partial vertebral height and improve kyphosis with similar clinical outcomes. PVP has a shorter operating time, is more economical, and can represent a therapeutic choice.

摘要

目的

本研究旨在探讨经皮椎体成形术(PVP)和经皮后凸成形术(PKP)治疗伴有后凸畸形的骨质疏松性椎体压缩骨折(OVCFs)的临床疗效。

方法

临床资料包括PVP组63例患者和PKP组70例患者。本研究评估了疼痛视觉模拟量表(VAS)、Oswestry功能障碍指数(ODI)、楔角(WA)、局部后凸角(LKA)和椎体高度。

结果

PVP组手术时间明显更短(p < 0.05)。同时,PKP组注入的骨水泥更多(p < 0.05),手术费用显著更高(p > 0.05)。与术前测量值相比,PVP组和PKP组术后VAS、ODI、WA、LKA和椎体高度均有显著改善(p < 0.05)。结果显示,两组在各随访时间点的VAS和ODI改善差异不显著(p > 0.05)。PKP组术后1天和3个月时椎体高度、WA和LKA改善更显著(p < 0.05),后续时间点组间差异不显著(p > 0.05)。两组中VAS的改善与WA、LKA或椎体高度的改善均无关(p > 0.05)。VAS的改善与注入的骨水泥量无关(p > 0.05);PKP组骨水泥渗漏发生率较低(12.9%;p < 0.05)。

结论

PVP和PKP均可恢复部分椎体高度并改善后凸畸形,临床效果相似。PVP手术时间更短,更经济,可作为一种治疗选择。

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