局麻下单侧与双侧PVP治疗老年骨质疏松性椎体压缩骨折的疗效比较

目的评估局麻下单侧或双侧经皮椎体成形术(PVP)治疗老年骨质疏松性椎体压缩骨折(OVCF)的近期、长期疗效。方法回顾性分析自2010年2月至2012年2月确诊为OVCF患者共117例(126个椎体)资料。117例均采用局麻下PVP治疗,分为单侧PVP组及双侧PVP组。最短随访时间2年,评估两组手术时间、射线暴露时间、视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分、术后近期及短期并发症。结果两组患者术前一般临床资料差异无统计学意义(P0.05);单侧PVP组与双侧PVP组在术前与术后,术后与末次随访VAS、ODI比较无统计学差异(P0.05);两组术后疗效较术前有明显差异(P0.05),总体渗漏率及其他椎体再骨折发生率比较无统计学差异(P0.05)。但单侧PVP组的手术时间及术中射线暴露时间比双侧PVP组减少(P0.05)。结论单侧与双侧PVP治疗老年OVCF的短期、长期效果肯定,但单侧椎弓根入路的手术具有时间短、射线暴露时间短的优点。

Comparison of unilateral and bilateral percutaneous vertebroplasty for treating aged osteoporotic vertebral compression fractures with local anesthesia.

Objective To evaluate short and long term effect of unilateral or bilateral percutaneous vertebroplasty （PVP） under local an- esthesia in the treatment of osteoporotic vertebral compression fracture（OVCF） for older adults. Methods We report a retrospective study of 117 （ 126 vertebral） patients, who were diagnosed with OVCF by our department from Feb 2010 to Feb 2012. Patients were assigned to two groups and received unilateral or bilateral PVP treatment under local anesthesia. The follower - up was performed at least for 2 years and designed to evaluate operative time, X - ray exposure time, VAS score, ODI score, short and long term complications after the surgery. Results There is no statistically significant difference in clinical materials between two groups before the surgery （ P 〉 0.05 ）. There is no statistically significant difference in VAS and ODI scores between unilateral and bilateral group before, after the surgery and at the final follow - up （ P 〉 0.05 ）. There is a significant difference in effectiveness between before and after surgery for both groups （ P 〈0. 01 ）, with no significant changes for total leakage rate and vertebral refracture rate （ P 〉 0.05 ）. However, the surgery time and x -ray exposure time is shorter in unilateral PVP compared to bilateral PVP （ P 〈 0.01 ）. Conclusion The short and long term effect is considered satisfactory for both unilateral and bilateral PVP. In addition, the unilateral PVP has advantages such as shorter operative time and X - ray exposure time. No short and long term complications were observed for both approaches.