经皮椎体后凸成形单侧与双侧穿刺注入骨水泥治疗骨质疏松性骨折

背景:研究表明经皮椎体后凸成形单侧与双侧穿刺注入骨水泥治疗骨质疏松性骨折的疗效存在差异。目的:比较经皮椎体后凸成形单侧与双侧穿刺注入骨水泥治疗骨质疏松性骨折的疗效差异。方法:将骨质疏松性椎体压缩性骨折患者随机分为单侧穿刺组和双侧穿刺组,经皮椎体后凸成形单侧或双侧穿刺注入骨水泥,随访期间定期摄脊柱正侧位X射线片,测量骨折椎体前缘、中部、后缘高度和后凸角度变化,采用疼痛目测类比法判断腰背痛的缓解情况,应用oswestry功能障碍指数评估生活质量,共随访12～36个月,平均26.3个月。结果与结论:单侧穿刺组每个椎体平均骨水泥注入量及穿刺时透视次数均低于双侧组(P<0.05)。穿刺前后两组间疼痛目测类比评分、Cobb角、oswestry功能障碍指数及椎体前缘、中部和后缘高度均差异无显著性意义。结果证实,单侧与经皮椎体后凸成形治疗骨质疏松性骨折与双侧穿刺的疗效相当,且放射暴露和骨水泥用量更少。

Unilateral versus bilateral percutaneous kyphoplasty for the treatment of osteoporotic compression fractures

BACKGROUND:There are differences between unilateral and bilateral percutaneous kyphoplasty for the treatment of osteoporotic compression fractures.OBJECTIVE:To evaluate the efficacy difference of unilateral versus bilateral percutaneous kyphoplasty for the treatment of osteoporotic compression fractures.METHODS:The patients with osteoporotic compression fractures were randomly divided into unilateral and bilateral puncture group.Patients underwent unilateral or bilateral kyphoplasty with bone cement.The X-ray film of lateral spinal was taken during follow-up.The changes of anterior,middle and posterior vertebral body height and the convex angle were measured.The pain visual analogue score was used to determine the relief of low back pain,and the oswestry functional disability index was used to assess the quality of life.A follow-up of 12-36 months was preformed with an average of 26.3 months.RESULTS AND CONCLUSION:The mean operation time,the mean volume of cement injected into one level and the times of intraoperative fluoroscopy of unilateral group was lower than that of bilateral group(P < 0.05).There were significant difference in pain visual analogue score,Cobb’s angle,oswestry functional disability index and the anterior,middle and posterior vertebral body height in two groups before puncture.Unilateral kyphoplasty for osteoporotic compression fractures is effective similar to bilateral kyphoplasty.But less time,fluoroscopy and cement were the advantage of unilateral kyphoplasty.