经皮椎体后凸成形术与经皮椎体成形术治疗老年胸椎压缩性骨折的临床效果比较

目的探讨经皮椎体后凸成形术(PKP)和经皮椎体成形术(PVP)治疗老年胸椎压缩性骨折的效果。方法选取2019年1月至2020年9月于我院治疗的老年胸椎压缩性骨折患者80例,根据手术差异性分为PVP组和PKP组,每组各40例,比较两组患者术中骨水泥注入量、术中透视时间、手术时间及术后并发症发生率及术前、术后3个月患者视觉模拟评分(Visual analogue scale,VAS)、伤椎前缘椎体高度及Cobb角。结果 PVP组患者骨水泥注入量为(4.79±0.92)mL,低于PKP组的(5.78±0.89)mL,术中透视时间为(8.14±1.02)min,手术时间为(28.15±6.63)min,短于PKP组的(9.94±1.38)min和(35.84±6.98)min,差异有统计学意义(P0.05);PVP组患者术后并发症发生率为27.50%,高于PKP组的10.00%,差异有统计学意义(P0.05);术前PKP组和PVP组患者的VAS评分、伤椎前缘椎体高度及Cobb角比较,差异无统计学意义(P0.05);术后3个月PKP组患者伤椎前缘椎体高度为(27.27±2.04)mm,高于PVP组的(22.45±2.47)mm;Cobb角为(10.25±1.22)°,低于PVP组的(13.42±1.73)°,差异有统计学意义(P0.05)。结论 PKP可有效恢复压缩性椎体高度、降低骨水泥渗漏率,PVP手术时间短,临床上对于身体状况好者可首选PKP;而对于椎体压缩程度不严重、Cobb角相对较小的患者可首选PVP。

Comparison of clinical effects of percutaneous kyphoplasty and percutaneous vertebroplasty in treatment of thoracic vertebral compression fractures in the elderly

Objective To explore the effects of percutaneous kyphoplasty(PKP) and percutaneous vertebroplasty (PVP)in the treatment of thoracic compression fractures in the elderly.Methods Eighty elderly patients with thoracic compression fractures who were treated in our hospital from January 2019 to September 2020 were selected and divided into the PVP group and the PKP group according to surgical differences,with 40 patients in each group.The intraoperative amounts of bone cement injection,intraoperative fluoroscopy time,operative time,incidences of postoperative complications,and visual analogue scales (VAS),anterior edge vertebral heights and Cobb Angles of the injured vertebra before and 3 months after surgery were compared between the two groups.Results The injection amount of bone cement in the PVP group was (4.79±0.92) mL,which was lower than that (5.78±0.89) mL in the PKP group;the fluoroscopy time(8.14±1.02)min and operation time (28.15±6.63)min were shorter than (9.94±1.38)min and (35.84±6.98) min in the PKP group;the differences were statistically significant (P<0.05).The incidence of postoperative complications in the PVP group was 27.50%,which was higher than the PKP group of 10.00%,and the difference was statistically significant (P<0.05).No statistical significances were observed in VAS scores,anterior vertebral heights and Cobb Angles between the PKP group and the PVP group before surgery (P>0.05).Three months after operation,in the PKP group,the height of the injured anterior vertebral body,(27.27±2.04)mm,was higher than (22.45±2.47)mm in the PVP group,and the Cobb Angle,(10.25±1.22)°,was lower than (13.42±1.73)° in the PVP group,with statistically significant differences (P<0.05).Conclusion PKP can effectively restore the height of the compressed vertebral body and reduce the leakage rate of bone cement.The operation time of PVP is short,so PKP is the first choice for patients with good physical conditions clinically,while PVP is the first choice for patients with less severe vertebral compression and relatively small Cobb Angles.