经皮椎体成形术与球囊扩张椎体后凸成形术治疗骨质疏松性椎体压缩骨折

[目的]研究经皮椎体成形术（PVP）和球囊扩张椎体后凸成形术（球囊PKP）对骨质疏松性椎体骨折（OVCF）的临床效果及探讨骨水泥渗漏的防治.[方法]收治75例骨质疏松性压缩性骨折患者,单侧或双侧椎弓根入路进针,根据手术方法不同分为PVP组及球囊PKP组,观察两组术前术后椎体高度变化、Cobb角变化、疼痛视觉模拟评分（VAS）、手术时间、手术出血量及骨水泥注射量,并分析防治骨水泥渗漏的方法.[结果]所有病例均成功地施行了PVP或球囊PKP,术中无椎管内骨水泥渗漏,术后患者疼痛明显缓解或消失,无一例出现严重并发症.两组疼痛缓解情况、手术时间、出血量及骨水泥注射量比较差异无统计学意义（ P 〉0.05）.PKP组对椎体高度的恢复和Cobb角改善情况优于PVP组,比较差异有统计学意义（ P 〈0.05）.[结论]PVP和球囊PKP术均是一种治疗骨质疏松压缩性骨折安全有效的方法,但对于恢复伤椎高度球囊PKP组优于PVP组.手术适应证的掌握和手术技术的提高是预防骨水泥渗漏的关键因素.

Percutaneous Vertebroplasty vs Balloon Percutaneous Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fracture

[Objective]To investigate the clinical efficacy of percutaneous vertebroplasty（PVP） vs balloon percutaneous kyphoplasty（PKP） in the treatment of osteoporotic vertebral compression fracture and to explore the prevention and treatment of bone cement leakage. [Methods] Totally 75 patients with osteoporotic vertebral compression fracture were collected and underwent the operation through unipedicular or bipedicular approach with PVP and PKP. According to the operation methods, they were divided into PVP group and balloon PKP group. The changes of vertebral height and Cobb＇s angle, visual analogue scale score（VAS）, operation time, intraoperative bleeding volume and the volume of bone cement injection were observed before and af- ter operation in two groups. The methods of the prevention and treatment of bone cement leakage were analyzed. [Results] All cases underwent PVP and balloon PKP successfully. No leakage of bone cement in verte bral canal was found in the operation, and the pain yvas obviously relieved or disappeared after operation. No severe complication occurred. There was no significant differences in the relief of the pain, operative time, bleeding volume and the volume of bone cement injection between two groups（ P 〈0. 05）. The recovery of vertebral height and the improvement of Cobb＇s angle in PKP group were superior to PVP group, and there was statistical significance between two groups（ P 〈0.05）. [Conclusion]PVP and balloon PKP are safe and effective procedures for the treatment of osteoporotic vertebral compression fracture, but balloon PKP for the recovery of vertebral height is superior to PVP. Mastering the indications of operation and improving the surgical techniques are the key factors for preventing the bone cement leakage.