椎体骨质疏松性骨折两种椎体成形术的疗效比较

 目的 比较经皮椎体成形术(percutaneous vertebroplasty,PVP)和经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗老年骨质疏松椎体压缩性骨折的疗效。方法 选取2017-01至2019-12医院收治的因骨质疏松椎体骨折行PVP或PKP治疗的老年患者共112例(132椎),根据选择术式的不同分为PVP组和PKP组,其中PVP组伤椎68个,PKP组伤椎64个。记录两种不同术式手术前后 VAS 评分、伤椎椎体增加高度、骨水泥注入量、手术时间、骨水泥渗漏情况。结果 PVP 组和PKP组术前和术后1 d的VAS评分比较,差异无统计学意义。PKP组术后修复伤椎高度为(11.5±3.2)mm,明显高于PVP组的(2.1±1.3)mm,差异有统计学意义(P<0.05)。PKP组骨水泥注入量也明显多于PVP组,两组比较差异有统计学意义(P<0.05)。PVP 组术中骨水泥渗漏 23个椎体(33.8%),PKP 组渗漏12个椎体(18.8%),PVP 组并发症高于PKP 组。结论 两种手术方式均能达到很好的止痛效果。但PKP恢复椎体高度上优于PVP,骨水泥注入量多,渗漏率低,临床治疗更有优势。

Percutaneous vertebroplasty vs percutaneous kyphoplasty for treating osteoporotic vertebral compression fractures

Objective To compare the clinical efficacy of percutaneous vertebroplasty (PVP)and percutaneous kyphoplasty(PKP)for osteoporotic vertebral compression fractures(OVCF).Methods One hundred and thirty-two vertebras from 112 patients underwent PKP or PVP between January 2017 and December 2019. Among them, 68 cases were treated with PVP and 64 cases received PKP. VAS scores were evaluated preoperatively and 1 day postoperatively separately. The height increase of the injured vertebra, bone cement leakage, bone cement injection volume and duration of surgery under the two different approaches were recorded.Results Preoperative and post-operative VAS scores were significantly different between the two groups. The height increase of the injured vertebra increased by (2.1±1.3) mm and (11.5±3.2) mm respectively for the PVP group and PKP group. Moreover, 23 cases in the PVP group and 12 cases in the PKP group suffered from bone cement leakage,so the difference between two groups was significant(P<0.05). The bone cement injection volume was (4.5±2.1) ml in the PVP group and (5.9±2.2) ml in the PKP group, with significant difference between the two groups.Conclusions PVP and PKP are both effective for pain relief,but PKP is better than PVP due to the greater height increase of the injured vertebra, larger PMMA injection volume and less PMMA leakage.