PKP与PVP对累及终板的OVCF短期疗效对比

目的对比经皮球囊扩张椎体后凸成形术(PKP)与经皮椎体成形术(PVP)对累及终板的胸腰椎骨质疏松性椎体压缩骨折(OVCF)的短期疗效。方法回顾性分析了累及终板的OVCF行PKP或PVP治疗的患者34例(34个椎体),男性9例,女性25例;年龄56~87岁,平均65.1岁。平均病程(4±2.7)d。记录并比较两组椎体高度恢复率、Cobb角恢复、骨水泥渗漏发生率、骨水泥用量、手术时间、VAS评分等指标。结果术后随访时间1个月,PKP较PVP的椎体高度恢复率更大,差异有统计学意义(P0.05);Cobb角恢复、骨水泥用量、手术时间、骨水泥渗漏发生率、VAS评分等两组之间差异无统计学意义(P0.05)。结论(1)在累及终板的OVCF中,PKP术式有助于椎体压缩最明显部位的高度恢复,故推荐使用PKP治疗。但PKP并不能降低骨水泥渗漏的风险。(2)球囊扩张时控制压力略低于产品规定的最大压力值,严格遵守操作规范,可以最大程度避免球囊破裂的发生。

Comparison of short-term effects between PKP and PVP in treating endplate involved OVCF

Objective To compare the short-term effects between PKP and PVP when treating endplate involved OVCFs.Methods Thirty-four patients(34 vertebrae) who suffered from endplate involved OVCFs and were treated by PKP or PVP were systematically reviewed.These patients consisted of 9 males and 25 females,with age ranged from 56 to 87 years,65.1 years on average.The average course of disease was (4±2.7) days.The restoration of the vertebral height and Cobb angle,cement leakage and consumption,operating time,and VAS scores were analyzed and compared.Results With one-month follow-up,the data showed that the PKP with balloon inflation appeared to be better in restoring the height of the middle vertebra than PVP,and the difference was statistically significant(P<0.05).The Cobb angle,cement leakage and consumption,operating time,and VAS scores were found not statistically different between the two groups(P>0.05).Conclusion 1.Balloon inflation helps restore the vertebral height in endplate involved OVCFs and thus it is recommended.But PKP cannot reduce the risk of cement leakage.2.When inflating the balloon,controlling the pressure slightly less than the maximum of the instruction can avoid balloon bursting.