单双侧穿刺入路PKP治疗老年骨质疏松椎体压缩性骨折的疗效对比

目的比较单、双侧穿刺球囊扩张椎体后凸成形术(PKP)治疗老年骨质疏松椎体压缩性骨折的疗效。方法选取东南大学附属南京江北人民医院2013年6月~2015年6月确诊并收治的老年骨质疏松椎体压缩性骨折患者96例,按照入院顺序单双号将其分为两组,单号次序入院为对照组,双号为观察组,均为48例。对照组采用双侧PKP进行治疗,观察组则采用单侧PKP治疗,所有患者均进行骨质疏松对症治疗。对比两组基本信息,如性别、年龄、体重、骨折部位等,观察并记录手术起始时间、术中骨水泥注射量、骨水泥渗漏数、透视次数等相关数据,分析两种入路方式的疗效差异。结果两组患者的性别、年龄、体重及骨折部位等入院一般资料的比较差异不明显(P0.05);术前两组患者的VAS评分、ODI指数、SF-36评分、椎体前缘、中间高度及Cobb角测量值等比较差异无统计学意义(P0.05);与术前相比,两组患者手术后的上述总体观察指标均有显著变化,比较差异有统计学意义(P0.05);但两组间上述各数据的比较仍无明显著差异(P0.05)。对照组手术过程中记录的手术时间、术中透视次数及骨水泥注入量分别为(42.2±10.3)min、(18.6±5.4)次、(4.5±0.5)m L,观察组依次为(68.8±12.5)min,(48.9±6.2)次,(6.1±0.6)m L,两组差异显著,有统计学意义(P0.05)。对照组术后邻近椎体再骨折数为6例,显著高于观察组的1例,有统计学意义(P0.05)。两组术后均未出现明显不良反应。结论与双侧穿刺入路相比,单侧穿刺入路PKP治疗老年骨质疏松椎体压缩性骨折在取得相同疗效的情况下简便有效,安全可靠,值得临床推广应用。

Comparison of unipedicular and bipedicular percutaneous kyphoplasty for elderly osteoporotic vetebral compression fractures

Objective To compare the efficacy of unipedicular percutaneous kyphoplasty (PKP) with the bipedicular one in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods Totally 96 patients with OVCF in our hospital were selected and divided into two groups according to their joining numbers.Odd numbers were the control group,and even numbers were the observation group,with 48 patients in each group.Patients in the control group were treated with bipedicular PKP,whereas the control group was treated with unipedicular PKP,and all the patients were given anti-osteoporosis medication treatment.Gender,age,weight,fracture sites and other general data were compared.VAS score,ODI index,SF-36 scale,Cobb's angle,as well as the operation time,intraoperative fluoroscopy times and bone cement injection and other data were compared,and the curative effect was analyzed.Results There was no difference in the general data such as gender,age,weight and fracture sites between the two groups(P>0.05);no difference was found in the VAS,ODI,SF-36,anterior/medium height of the vertebrae body,and Cobb's angle.Compared with the data before operation,the above indexes of two groups were all significantly improved(P<0.05),but the differences between the two groups were not significant(P>0.05).The operation time,intraoperative fluoroscopy times and bone cement injection in the control group were (42.2±10.3) min, (18.6±5.4),(4.5±0.5) mL,respectively,significantly different from those in the observation group[(68.8±12.5) min,(48.9±6.2),(6.1±0.6) mL,P<0.05].Postoperative adjacent vertebral fracture occurred again in 6 cases in the control group,while only in one case in the observation group,and there was statistical significance (P<0.05).No adverse reaction happened in either group.Conclusion Compared with bipedicular PKP,the unipedicular one is more simple and efficient to get the same result,and it is safe and worthy to be promoted.