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经皮椎体后凸成形术与经皮椎体成形术治疗骨质疏松性椎体压缩骨折的临床疗效:单中心倾向评分匹配研究。

Clinical Effect of Percutaneous Kyphoplasty and Percutaneous Vertebroplasty in Managing Osteoporotic Vertebral Compression Fractures: A Single-Center Propensity Score-Matched Study.

机构信息

Department of Orthopedics, Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, 215000 Suzhou, Jiangsu, China.

Department of Orthopedics, People's Hospital of Dejiang, 565200 Dejiang, Guizhou, China.

出版信息

Ann Ital Chir. 2024;95(5):848-858. doi: 10.62713/aic.3634.

DOI:10.62713/aic.3634
PMID:39467787
Abstract

AIM

This study aims to evaluate the clinical effectiveness of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in managing osteoporotic vertebral compression fractures (OVCFs).

METHODS

This retrospective study included 268 elderly OVCF individuals, and 144 individuals were selected after propensity score matching. General patient information, perioperative conditions, vertebral height and Cobb angle, lumbar spinal function, degree of pain, incidence of complications, and fracture recurrence rates were compared and analyzed for the patients.

RESULTS

The PKP group exhibited longer surgical duration, greater intraoperative blood loss, and more frequent X-ray fluoroscopy during the perioperative period compared to the PVP group (p < 0.05). However, there was no significant difference in the length of hospital stay between the two groups. Furthermore, PKP surgery significantly improved vertebral height, corrected spinal posture, and enhanced lumbar spinal function while mitigating pain levels within the 12-month postoperative period (p < 0.05). Additionally, the PKP group showed substantially lower rates of bone cement leakage, nerve injury, and fracture recurrence than the PVP group (p < 0.05).

CONCLUSIONS

Compared to PVP, PKP demonstrates better clinical effectiveness with lower incidence of complications in managing OVCF. However, surgical time and intraoperative trauma should be considered.

摘要

目的

本研究旨在评估经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩性骨折(OVCF)的临床疗效。

方法

本回顾性研究纳入了 268 例老年 OVCF 患者,经倾向评分匹配后选择了 144 例患者。比较分析了两组患者的一般患者信息、围手术期情况、椎体高度和 Cobb 角、腰椎功能、疼痛程度、并发症发生率和骨折复发率。

结果

与 PVP 组相比,PKP 组围手术期手术时间更长、术中出血量更大、X 线透视次数更多(p<0.05),但两组患者住院时间无显著差异。此外,PKP 手术可显著改善术后 12 个月的椎体高度、纠正脊柱姿势、增强腰椎功能,同时减轻疼痛程度(p<0.05)。此外,PKP 组的骨水泥渗漏、神经损伤和骨折复发率明显低于 PVP 组(p<0.05)。

结论

与 PVP 相比,PKP 治疗 OVCF 的临床疗效更好,并发症发生率更低,但应考虑手术时间和术中创伤。

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