经皮椎体成形术和经皮球囊扩张椎体后凸成形术治疗骨质疏松性胸腰椎压缩骨折的疗效对比

目的比较经皮椎体成形术与经皮球囊扩张椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折的临床疗效。方法将76例患者随机分为实验组(经皮椎体成形术组)和对照组(经皮球囊扩张椎体后凸成形术组),比较两组患者不同手术方式的手术时间、术中失血量、骨水泥注入量、渗漏率,手术前后的VAS评分、Cobb's角和椎体高度,以及术后1月和1年疗效比较。结果两种手术方式均有显著效果,两组比较术中出血量和手术时间差异无统计学意义(P>0.05),骨水泥注入量和渗漏率有统计学差异(P<0.05);术后两组VAS评分、Cobb's角和椎体高度均较术前有明显改善(P<0.05),但两组间比较差异无统计学意义(P>0.05),术后1月和1年的有效率差异无统计学意义(P>0.05)。结论两种术式对于骨质疏松性胸腰椎压缩骨折均有较好的疗效,均有出血量少、手术时间短、创伤小等特点,PVP操作较为简单,但其骨水泥渗漏率较高,PKP可大大降低骨水泥渗漏的发生率,对于后凸畸形可有效纠正,安全性更高。

A Comparison of the Curative Effect of PVP and PKP for Osteoporotic Thoracolumbar Compression Fractures

Objective To compare the curative effect of percutaneous vertebroplasty （PVP） and percutaneous kyphoplasty （PKP） for osteoporotic thoracolumbar compression fractures. Methods 76 patients were randomly divided into the experimental group （Group PVP） and the control group （Group PKP）. The outcome was a comparative analysis of length of operation, blood loss volume, amount of bone cement injection, leakage rate, preoperative and postoperative VAS scores, Cobb ＆#39;s angle and vertebral height, as well as curative effect after 1 month and 1 year of operation. Results Both of the two groups were effective. The intraoperative blood loss and length of operation were similar between the two groups, with no statistical significance （P〉0.05）. The rate of leakage of the amount of bone cement injection were statistically significant （P〈0.05）. The postoperative VAS score, Cobb＇s angle and vertebral height were improved after surgery （P〈0.05）, but the differences had no statistical significance between the two groups （P〉0.05）. The efficieny after 1 month and 1 year were not statistically different （P〉0.05）. Conclusions Both of the operative methods for osteoporotic thoracolumbar compression fractures have good curative effect, with less blood loss, shorter length of operation and smaller trauma. PVP therapy is relatively simple, but its rate of bone cement leakage is higher, while PKP therapy can greatly reduce the incidence of leakage of bone cement, effectively correct the kyphosis and get higher security.