单侧椎弓根旁入路与双侧椎弓根入路行椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的效果比较

目的比较单侧椎弓根旁入路与双侧椎弓根入路治疗骨质疏松性椎体压缩性骨折（OVCF）的临床效果，为该类疾病的治疗提供临床参考。方法选择徐州市中心医院2008年3月．2011年3月收治的OVCF患者98例。根据术式不同分为单侧椎弓根旁入路组及双侧椎弓根入路组。单侧椎弓根旁入路组（46例78椎）使用单侧椎弓根旁入路行椎体后凸成形术（PKP）治疗，双侧椎弓根人路组（52例74椎）使用双侧椎弓根入路行PKP治疗。对两组患者的VAS评分变化、手术时间、住院时间、伤椎体高度改变等指标进行评价。结果①单侧椎弓根旁入路组手术时间[（28±8）min]明显短于双侧椎弓根旁入路组[（37±12）min]，差异有统计学意义（P〈0．05）；骨水泥灌注量、住院时间两组比较差异无统计学意义（P〉0．05）。②两组患者术后48h和3个月时VAS评分低于术前。前部及中部伤椎高度均高于术前，差异均有统计学意义（P〈0．05）。两组术后48h时VAS评分、前部及中部伤椎高度比较，差异无统计学意义（t=0．914、1．103、0．697，P〉0．05）；两组术后3个月时VAS评分、前部及中部伤椎高度比较，差异无统计学意义（t=0．713、0．932、0．715，P〉0．05）。结论单侧椎弓根旁入路与双侧椎弓根入路行PKP均可以改善运动功能和减轻疼痛，可安全增加椎体高度，且单侧椎弓根旁入路PKP术具有手术时间短的优点。

Comparison about the clinical effect of unilateral pedicle side kyphoplasty and bilateral transpedicular kyphoplasty for the patients with osteoporotic vertebral compression fractures

Objective To evaluate the clinical efficacy of unilateral pedicle side kyphoplasty and bilateral transpedicular kyphoplasty for the patients with osteoporotic vertebral compression fractures （OVCF）, and to provide a clinical reference for the disease. Methods 98 patients with OVCF from March 2008 to March 2011 in Central Hospital of Xuzhou City were selected and divided into unilateral pedicle side kyphoplasty group and bilateral transpedicular kyphoplasty group. 46 patients （78 centrum） were treated with unilateral pedicle side kyphoplasty, 52 cases （74 centrum） were treated with unilateral pedicle side kyphoplasty. The changes of VAS score, the operation time, the hospitalization time, and the changes of vertebral height of the two groups were evaluated. Results ①The operation time of unilateral pedicle side kyphoplasty group [（28±8） mini was shorter than that of bilateral transpedieular kyphoplasty group [（37±12） min], the difference was statistically significant （P 〈 0.05）; the differences of bone cement perfusion, hospitalization time between the two groups were not statistically significant （/9 〉 0.05）.②The differences of VAS scores 48 hours, 3 months after the operation in the two groups were all lower than that before the operation, the front and central injured vertebral height 48 hours, 3 months after the operation in the two groups were all higher than those before the operation, the difference was statistically significant （P 〈 0.05）. The differences of VAS scores, the front and central injured vertebral height 48 hours after the operation between the two groups were not statistically significant （t = 0.914, 1.103, 0.697, P 〉 0.05）; the differences of VAS scores, the front and central injured vertebral height 3 months after the operation between the two groups were not statistically significant （t = 0.713, 0.932, 0.715, P 〉 0.05）. Conclusion Both unilateral pedicle side kyphoplasty and bilateral transpedieular kyphoplasty can improve the motor function and pain and increase the height of vertebral body for the patients with osteoporotic vertebral compression fractures,and unilateral pedicle side approach kyphoplasty has a advantage of short operation time.