Xu Dingli, Ruan Chaoyue, Wang Yang, Hu Xudong, Ma Weihu
Health Science Center, Ningbo University Zhejiang, Ningbo, China.
Orthopedic Department, Ningbo No. 6 Hospital, Zhejiang, Ningbo, China.
Front Surg. 2024 Jul 18;11:1395289. doi: 10.3389/fsurg.2024.1395289. eCollection 2024.
Osteoporosis vertebral compression fractures (OVCF) are common with the aging process. This study aimed to compare the effects of unilateral transverse process extrapedicular (UEPKP) and bilateral transpedicular percutaneous kyphoplasty (BTPKP) for patients with thoracolumbar OVCF.
Data from 136 patients with OVCF treated with single-level PKP in our hospital between May 2019 and April 2021 were studied. Patients were grouped based on surgical procedure: there were 62 patients in the UEPKP group and 74 in the BTPKP group. All clinical and radiological data were collected from medical records. Clinical outcomes, including visual analog scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores of the lumbar spine, were evaluated preoperatively, postoperatively, and at the follow-up visit. The radiological evaluations (anterior vertebral height rate and local kyphosis angle) and complications were also collected.
All patients had successfully improved after surgery. In the UEPKP group, patients showed a significantly shorter operating time and lower fluoroscopy frequency than patients in the BTPKP group ( < 0.05). However, a significantly better distribution score and cement volume were found in the BTPKP group ( < 0.05). The UEPKP group achieved a significantly better VAS score (0.6 ± 0.5 vs. 0.9 ± 0.8) and ODI (24.7 ± 3.1 vs. 27.5 ± 1.8) at the final follow-up visit than the BTPKP group ( < 0.05). The UEPKP group showed significantly worse radiological outcomes (anterior height rate and local kyphosis angle) at the 6- and 12-month follow-ups ( < 0.05). As for complications, the UEPKP group showed significantly fewer facet joint violations and intraspinal leakages ( < 0.05).
UEPKP could be a safe and effective alternative procedure for patients with thoracolumbar osteoporotic vertebral compression fracture, which possesses an apparent advantage in reducing intraspinal leakage and facet joint violation over BTPKP.
骨质疏松性椎体压缩骨折（OVCF）随着衰老过程而常见。本研究旨在比较单侧横突椎弓根外（UEPKP）和双侧经皮椎弓根椎体后凸成形术（BTPKP）治疗胸腰椎OVCF患者的效果。
研究我院2019年5月至2021年4月间136例行单节段PKP治疗的OVCF患者的数据。根据手术方式将患者分组：UEPKP组62例，BTPKP组74例。所有临床和影像学数据均从病历中收集。评估术前、术后及随访时的临床结果，包括视觉模拟量表（VAS）、Oswestry功能障碍指数（ODI）和腰椎日本骨科协会（JOA）评分。还收集影像学评估指标（椎体前缘高度率和局部后凸角）及并发症情况。
所有患者术后均成功改善。UEPKP组患者的手术时间明显短于BTPKP组，透视频率也低于BTPKP组（P<0.05）。然而，BTPKP组的分布评分和骨水泥用量明显更好（P<0.05）。在末次随访时，UEPKP组的VAS评分（0.6±0.5 vs. 0.9±0.8）和ODI（24.7±3.1 vs. 27.5±1.8）明显优于BTPKP组（P<0.05）。在6个月和12个月随访时，UEPKP组的影像学结果（椎体前缘高度率和局部后凸角）明显更差（P<0.05）。至于并发症，UEPKP组的小关节侵犯和椎管内渗漏明显更少（P<0.05）。
UEPKP对于胸腰椎骨质疏松性椎体压缩骨折患者可能是一种安全有效的替代手术，与BTPKP相比，在减少椎管内渗漏和小关节侵犯方面具有明显优势。
