PKP及PVP术治疗骨质疏松性椎体压缩骨折的临床对比研究

目的探讨体位+手法复位结合PVP术治疗OVCF的方法及临床价值。方法 2007年2月～2012年5月采用微创介入治疗OVCF患者132例,其中68例89个椎体行体位+手法复位结合PVP,64例81个椎体行PKP,所有患者随访3年以上。手术前后采用VAS评分、ODI指数、病椎前缘、中部高度的变化及后凸畸形Cobb's角等指标来评估疗效,并观察两组手术时间、术中透视时间、骨水泥渗漏、骨水泥注入量及住院费用、天数情况。结果两组术后VAS评分及ODI指数有明显下降,与术前相比差异有统计学意义(P<0.001),但术后同一时间点两组间比较差异无统计学意义(P>0.05)。两组椎体高度及后凸畸形与术前比较差异有统计学意义(P<0.001),但两组在矫形效果上比较差异无统计学意义(P>0.05)。PVP组8个椎体(9.0%)、PKP组7个椎体(8.6%)出现骨水泥渗漏,但均无神经症状。结论体位+手法复位结合PVP术治疗OVCF能达到与PKP相同的中期临床效果,并能有效恢复病椎高度,矫正脊椎后凸畸形,且骨水泥渗漏发生率低。

Clinical comparative study of PKP and PVP in the treatment of osteoporotic vertebral compression fractures

Objective To explore the method and clinical value of restitution combined with percutaneous vertebroplasty for treating vertebral compression fracture of osteoporosis.Methods From Feb 2007 to May 2012,132 patients with osteoporotic vertebral compression fractures underwent minimally invasive techniques and completed the Follow-up of more than 3 years.Among them 68 cases with 89 vertebral bodies underwent restitution combined with PVP,64 cases with 81 vertebral bodies underwent PKP.The results of VAS and ODI,Cobb angle,vertebral body and disc height were separately compared between the PVP group and the PKP group.Results Postoperative VAS scores and ODI index of all patients decresed obviously with a snificant difference(P < 0.001),and the changes of postoperative VAS scores and ODI index had no significant difference(P > 0.05) in the tow groups at the same time point.All patients had significant difference(P < 0.001) in the restoration of vertebra height and kyphosis improvement compared with that of preoperation,and there was no significant difference(P > 0.05) between the PVP group and the PKP group in the orthopedic results.Eight vertebral bodies(9.0%) in the PVP group,seven(8.6%)in the PKP group complicated with cement leakage,but all did not have nervous symptom.Conclusion Restitution combined with PVP in the treatment of osteoporosis can achieve the same medium with the PKP clinical results,and can effectively restore vertebral height and correction of spinal kyphosis,and a low incidence of bone cement leakage.