Zhou Qiang, Wan Yanlin, Ma Le, Dong Liang, Yuan Weijian
Department of Orthopaedics, Tianjin First Central Hospital, Tianjin, People's Republic of China.
Clin Interv Aging. 2024 Feb 17;19:289-301. doi: 10.2147/CIA.S438036. eCollection 2024.
The purpose of this study is to compare the refracture rate of the cemented vertebral body of percutaneous curved vertebroplasty (PCVP) and bilateral percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fractures (OVCF).
Ninety-four patients with single segment thoracolumbar OVCF were randomly divided into two groups (47 patients in each) and underwent PCVP or bilateral PKP surgery, respectively. Refracture of cemented vertebral body, bone cement injection volume and cement pattern, cement leakage rate, total surgical time, intraoperative fluoroscopy time, preoperative and postoperative Cobb angles and anterior vertebral height, Oswestry disability index questionnaire (ODI) and visual analog scales (VAS) were recorded.
The PCVP group had significantly lower refracture incidence of the cemented vertebral than the bilateral PKP group (p<0.05). There was a significant postoperative improvement in the VAS score and ODI in both group (p<0.01), and no significant difference was found between two groups. The operation time and intraoperative fluoroscopy times were significantly less in the PCVP group than in the bilateral PKP group (p<0.01). The mean kyphosis angle correction and vertebral height restoration in the PCVP group was significantly less than that in the bilateral PKP group (p<0.01).
Both PCVP and PKP were safe and effective treatments for OVCF. The PCVP had lower refracture rate of the cemented vertebral than the bilateral PKP group, and PCVP entailed less exposure to fluoroscopy and shorter operation time than bilateral PKP.
本研究旨在比较经皮弯角椎体成形术(PCVP)与双侧经皮后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)时骨水泥强化椎体的再骨折率。
94例单节段胸腰椎OVCF患者随机分为两组(每组47例),分别接受PCVP或双侧PKP手术。记录骨水泥强化椎体的再骨折情况、骨水泥注入量及分布模式、骨水泥渗漏率、总手术时间、术中透视时间、术前及术后Cobb角和椎体前缘高度、Oswestry功能障碍指数问卷(ODI)及视觉模拟评分(VAS)。
PCVP组骨水泥强化椎体的再骨折发生率显著低于双侧PKP组(p<0.05)。两组术后VAS评分和ODI均有显著改善(p<0.01),两组间差异无统计学意义。PCVP组的手术时间和术中透视时间显著少于双侧PKP组(p<0.01)。PCVP组的平均后凸角矫正和椎体高度恢复显著低于双侧PKP组(p<0.01)。
PCVP和PKP都是治疗OVCF的安全有效的方法。PCVP组骨水泥强化椎体的再骨折率低于双侧PKP组,且PCVP比双侧PKP的透视暴露少、手术时间短。