椎体后凸成形术和椎体成形术治疗骨质疏松性椎体骨折疗效的对比研究

目的探讨椎体后凸成形术（percutaneou8kyphoplasty，PKP）和椎体成形术（percutaneousvertebroplasty，PVP）在治疗骨质疏松性椎体骨折中的应用。方法共562例骨质疏松性椎体骨折，采用PVP治疗256例，PKP治疗306例。统计分析手术前后视觉模拟疼痛评分（vAS）、SF-36评分系统、伤椎高度及后凸畸形的X线片测量。结果患者获随访6。12个月，术后症状缓解，无神经损伤，骨水泥渗漏并发症2组比较差异无统计学意义fP〉0．05）。2组手术前后VAS和SF-36评分比较，差异有统计学意义（P〈0．05）；PKP组术前与术后1周、6个月椎体高度恢复率、椎体后凸角度改善率与PVP组比较，差异有统计学意义（P〈0．05）；PKP组的术后12个月和术后6个月的椎体压缩率、后凸角度比较，差异有统计学意义（P〈O．05）。结论PVP与PKP均可显著缓解椎体压缩骨折患者的疼痛，PKP矫正椎体高度及改善后凸畸形比PVP好；骨水泥渗漏发生率2组相当。

Comparative study of vertebroplasty and kyphoplasty therapy of osteoporotic vertebral compression fracture

Objective To compare clinical outcomes between percutaneous kyphoplasty （PKP） and percutaneous vertebroplasty （PVP） in treatment of senile osteoporofic vertebral compression fractures （VCF）. Methods Five hundred and sixty two patients were divided into two treatment group： PVP （256 patients） versus PKP （360 patients）. Preoperative and postoperative parameters comprised： Visual Analogue Score （VAS）, SF-36 analysis system, height of fractured vertebral bodies and kyphosis angles. Results All patients had 6-12 months follow-up. Statistical analysis showed no difference in symptoms alleviation, nerve damage and cement leakage between two groups （P 〉0.05）. Preoperative and postoperative VAS had difference in each group. SF-36 analysis system was same as VAS （P 〈0.05）. Improvements of vertebral body height and kyphosis angle in PKP group and PVP group had statistical difference （P 〈0.05）. Improvements of vertebral body height between 6 and 12 months after procedures showed significant difference in PKP group （P 〈0.05）. Conclusion Both PVP and PKP procedures can release pain caused by VCF. PKP procedure does better than PVP in improving vertebral body height and kyphosis angle. But both groups have no difference in cement leakage.