摘要
目的观察经皮椎体成形术(Percutaneous vertebroplasty,PVP)和经皮椎体后凸成形术(Percutanous kyphoplasty,PKP)治疗重度骨质疏松性椎体压缩骨折的临床疗效、可行性、安全性。方法回顾性分析2006年1月至2010年12月收治重度骨质疏松性椎体压缩骨折患者并获得随访34例,PVP治疗19例25个椎体,PKP治疗15例20个椎体。观察两组患者间SF-36评分、伤椎高度恢复、骨水泥渗漏及随访期间伤椎高度丢失情况、临近椎体骨折情况。结果 PVP组和PKP组患者在术中骨水泥渗漏率、末次随访时SF-36评分、末次随访时临近椎体骨折发生率间差异无统计学意义(P>0.05)。在椎体复位效果的观察指标上,PKP组术后椎体前缘间、椎体上下终板中心间高度恢复量、术后后凸角度恢复值、末次随访后凸角度恢复值上与PVP组间差异有统计学意义(P<0.05),同时在末次随访时PKP组伤椎高度丢失量与PVP组差异也有统计学意义(P<0.05)。结论 PVP和PKP治疗重度骨质疏松性椎体压缩性骨折均可显著改善患者症状,PKP具有较好的复位效果,但术后椎体高度丢失明显,在骨水泥渗漏率、相邻椎体骨折发生率指标上相对于PVP未表现出明显优越性。
Objective To observe the clinical efficacy, feasibility, and safety of percutaneous vertebroplasty （PVP） and kyphoplasty （PKP） for the treatment of severe osteoporotic vertebral compressive fractures. Methods Thirty-four patients with severe osteoporotic compressive fractures were retrospectively analyzed, including 19 patients （25 vertebral bodies） treated with PVP and 15 patients （20 vertebral bodies） treated with PKP, from Jan 2006 to Dec 2010. The SF-36 score, height improvement of damaged vertebral bodies, the leak of bone cement, the height loss of damaged vertebral bodies during follow up, and the fracture of adjacent vertebra between the two groups were observed and compared. Results The differences of SF-36 score, bone cement leakage in the operation, and adjacent vertebra fracture at the last follow-up between the PVP and PKP group were not significant （P 〉 O. 05）. When the vertebra recovery effect was observed, the recovery of the anterior vertebra height, center vertebra height, vertebra Cobb angle, and vertebra kyphosis angle after the operation in PKP group was significantly different compared to those in PVP group （P 〈 0.05）. As the last follow up, the loss of damaged vertebra height in PKP group was different compared to that in PVP group （P 〈 0. 05）. Conclusion Both PVP and PKP can significantly relieve the symptoms in severe osteoporotic vertebral compressive fracture patients. The replacement efficacy of PKP is comparatively better than that of PVP. However, PKP is not superior in height loss of damaged vertebra after operation, leakage rate of bone cement, and incidence of adjacent vertebra fracture compared to PVP.
出处
《中国骨质疏松杂志》
CAS
CSCD
2011年第11期969-973,共5页
Chinese Journal of Osteoporosis
关键词
经皮椎体成形术
椎体后凸成形术
骨质疏松性椎体压缩性骨折
Percutaneous vertebroplasty
Percutaneous kyphoplasty
Osteoporotic vertebral compressive fractures
