两种术式治疗胸腰椎椎体压缩性骨折的疗效比较

目的 观察经皮椎体成形术(PVP)、经皮球囊扩张椎体后凸成形术(PKP)对胸腰椎椎体压缩性骨折患者脊柱-骨盆矢状位参数的影响.方法 回顾性分析2016 年5 月至2018 年5 月在中日友好医院接受PVP 或PKP 治疗的 120 例新鲜单节段胸腰椎椎体压缩性骨折患者临床资料,按术式分为PVP组(67 例)和PKP组(...

Comparative evaluation of two surgical methods treating patients with thoracolumbar vertebral compression fractures

Objective To observe the effects of percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)on spinalpelvic sagittal parameters in patients with thoracolumbar vertebral compression fractures(TVCF).Methods The clinical data of 120 patients with fresh single-segment TVCF undergoing PVP or PKP in the hospital from May 2016 to May 2018 were retrospectively analyzed.According to the surgical methods,patients were divided into the PVP group(n=67)and PKP group(n=53).The general surgical situations,spinalpelvic sagittal parameters,postoperative vertebral recovery,pain and dysfunction were compared between both groups.Results No serious complications were observed in any group.The operation duration and injection volume of bone cement in the PVP group were significantly lower than those in the PKP group,while the leakage rate of bone cement was significantly higher than that in the PKP group.Postoperatively,lumbar lordosis and sacral slope were significantly increased in both groups,while pelvic tilt and C₇sagittal vertical axis were significantly decreased;there was no significant difference between both groups(P<0.05).There was no significant difference in rate of vertebral compression between the two groups.At the last follow-up,recovery rate of vertebral height in the PVP group was significantly lower than that in PKP group,while loss rate of vertebral height was significantly higher than that in the PKP group(P<0.05);there was no significant difference in rate of vertebral compression between both groups.The visual analogue scale and Oswestry dysfunction index in both groups were significantly decreased postoperatively,but they were significantly higher in the PVP group compared with those of the PKP group(P<0.05).Conclusion Both PVP and PKP can recover the overall spine-pelvic sagittal balance to certain extent in the treatment of TVCF.The leakage rate of bone cement resulting from PKP is lower than the PVP,thus facilitating postoperative vertebral height recovery and dysfunction improvement.