PKP 与 PVP 治疗骨质疏松性椎体压缩骨折的临床效果比较

目的：探讨经皮椎体后凸成形术（ PKP）治疗椎体骨质疏松致椎体压缩骨折的临床效果。方法按照入院顺序将2011年1月至2013年7月收治的91例椎体骨质疏松致椎体压缩性骨折患者分为PKP组（45例）和PVP组（46例），PKP组采用经皮椎体后凸成形术治疗，PVP组采用经皮椎体成形术治疗，比较2组患者治疗后的VAS评分、Cobb角、椎体高度、ODI评分等指标的变化情况。结果 PKP组患者的评价2手术时间（38\．4±8．2）min、骨水泥注入量（6．1±1．8）ml均显著大于PVP组，但骨水泥渗漏椎体数显著的低于PVP组（ P <0．05）。术前PKP组和PVP组的VAS评分、Cobb角、椎体高度、ODI评分差异无统计学意义（ P >0．05）；术后1周、术后6个月2组患者的VAS评分较治疗前均显著的降低（ P <0．05），2组间差异无统计学意义（ P >0．05）；术后6个月，PKP组的Cobb角（17．1±1．6）度、椎体高度（78．9±7．2） mm、ODI评分（14．2±2．5）分均显著的优于同期PVP组患者（ P <0．05）。结论对于椎体骨质疏松致椎体压缩性骨折患者采用PVP与PKP均能够取得较好的疗效，但PKP对于术后椎体高度恢复、Cobb角恢复、功能恢复等效果更加显著。

Comparison of therapeutic effects between PKP and PVP on osteoporotic vertebral compression fracture

Objective To investigate the therapeutic effects of percutaneous kyphoplasty ( PKP ) on osteoporotic vertebral compression fractures .Methods According to the order of admission to Department of Orthopedics , the 91 patient with osteoporotic vertebral compression fractures who were admitted and treated in our hospital from January 2011 to July 2013 were divided into PKP group ( n =45) and PVP group ( n =46).The patients in PKP group were treated by percutaneous kyphoplasty (PKP),however,the patients in PVP group were treated by percutaneous vertebroplasty (PVP),after treatment, the VAS score , Cobb angle , vertebral height , ODI score were detected and compared between two groups .Results The operation time (38.4 ±8.2)min,bone cement injection volume (6.1 ±1.8)ml in PKP group were significantly greater than those in PVP group,however, the number of vertebral body of bone cement seepage was obviously less than that in PVP group ( P <0.05).Before treatment,there were no significant differences in VAS score ,Cobb angle, vertebral height,ODI score between two groups ( P >0.05),however, the VAS scores on 1w,6m after operation were significantly decreased in both groups,as compared with those before treatment ( P <0.05),but there were no significant differences between two groups (P>0.05).On 6 months after operation,the Cobb angle (17.1 ±1.6),vertebral height (78.9 ±7.2) mm,ODI score (14.2 ±2.5 points) in PKP group were superior to those of PVP group ( P <0.05).Conclusion Both PVP and PKP have better therapeutic effects on osteoporotic vertebral compression fractures , but PKP has more obvious effects on postoperative recovery of vertebral height ,Cobb angle and function recovery .