单侧与双侧入路经皮椎体后凸成形术治疗胸腰椎体压缩性骨折的近期疗效对比

目的 探究单侧与双侧入路经皮椎体后凸成形术(PKP)治疗胸腰椎体压缩性骨折病人的近期疗效.方法 选取徐州市铜山区人民医院2018年2月至2019年6月收治的92例胸腰椎体压缩性骨折病人,采用随机数字表法分为两组,各46例.观察组行单侧入路PKP治疗,对照组行双侧入路PKP治疗.对比两组视觉模拟评分法(VAS)评分、椎体及Cobb角恢复度、骨水泥量及渗漏率、透视次数和手术时间情况.结果 两组术前、术后VAS评分的差异无统计学意义(P>0.05),观察组、对照组术后3个月的VSA评分分别为(2.54±0.51)分、(2.65±0.42)分,均低于术前(7.38±1.96)分、(7.25±2.01)分(P<0.05).两组椎体前缘、中间恢复高度及Cobb角恢复度、骨水泥渗漏率之间差异无统计学意义(P>0.05).观察组手术时间为(24.18±6.83)min,短于对照组(34.58±7.14)min;透视次数为(16.17±4.05)次,少于对照组(27.69±4.28)次;骨水泥量为(4.38±1.04)mL,少于对照组(5.22±1.17)mL(均P<0.05).结论 单侧或双侧入路PKP治疗胸腰椎体压缩性骨折病人均可有效缓解疼痛感,纠正脊柱后凸畸形,而单侧入路PKP的手术时间更短,并可减少放射暴露.

Comparison of the short-term efficacy of PKP through unilateral or bilateral approaches in the treatment of thoracolumbar vertebral compression fractures

Objective To explore the short-term efficacies of unilateral and bilateral percutaneous kyphoplasty (PKP) in the treatment of thoracolumbar vertebral compression fractures.Methods Ninety-two patients with thoracolumbar vertebral compression fractures admitted to Tongshan People''s Hospital of Xuzhou City from February 2018 to June 2019 were assigned into two groups by random number table, with 46 cases in each group. The observation group was treated with unilateral approach and the control group wastreated with bilateral approach. A comparison was made between the two groups of visual analogue scale (VAS) score, recovery of vertebral body and Cobb angle, amount of bone cement and leakage rate, fluoroscopy times and operation time.Results There was no significant difference in VAS scores before and after operation between the two groups (P>0.05). The VSA scores of the observation groupand the control group at 3 months after operation were (2.54±0.51) and (2.65±0.42) respectively, which were lower than those before operation (7.38±1.96), (7.25±2.01); P<0.05]. There were no significant differences in the recovery of anterior vertebral body height, central vertebral body height and Cobb angle, and the leakage rate of bone cement between the two groups (P>0.05). The operation time ofthe observation group was (24.18±6.83) min, shorter than that of the control group (34.58±7.14) min], the fluoroscopy times was (16.17± 4.05), less than that of the control group (27.69±4.28)], and the bone cement volume was (4.38 ± 1.04) mL, less than that of the control group (5.22±1.17) mL] (all P<0.05).Conclusion PKP through unilateral or bilateral approaches can effectively relieve pain andcorrect kyphosis in patients with thoracolumbar vertebral compression fractures, while PKP through unilateral approach can shorten theoperation time and reduce radiation exposure.