PVP与PKP治疗骨质疏松性胸腰椎压缩性骨折的近远期疗效比较

目的 比较经皮椎体成形术(Perculaneous vertebroplasty,PVP)和经皮椎体后凸成形术(Percutaneous kyphosis,PKP)治疗骨质疏松性胸腰椎压缩性骨折的近远期疗效.方法 回顾分析2015年12月至2017年5月收治的135例骨质疏松性脊柱骨折患者的临床资料.患者根据手术方式的...

Comparison of Short-and Long-Term Effects of PVP and PKP in the Treatment of Osteoporotic Thoracolumbar Vertebral Compression Fractures

Objective To compare the short-and long-term effects of percutaneous vertebralplasty(PVP)and percutaneous kyphosis(PKP)in the treatment of osteoporotic thoracolumbar vertebral compression fractures.Methods A total of 135 patients with osteoporotic spinal fractures from December 2015 to May 2017 were enrolled and retrospectively analyzed.According to the different surgical method,patients were randomly divided into 2 groups:PVP group(n=70)and PKP group(n=65).The patients were followed up for 24 months.The efficacy was evaluated 2 months after surgery.The pain VAS score,the vertebral anterior margin height ratio,Cobb angle,and Oswestry disability index(ODI)were evaluated before surgery,1 day,1 week,1 month,3 months,12 months and 24 months after surgery.The cement leakage were recorded 1 month after surgery.New vertebral fractures and total fractures were recorded in all patients.Results Compared with PVP group,the total effective rate of PKP group was higher(P<0.05).Before surgery and 1 day after surgery,there were no significant differences in VAS,ODI,vertebral anterior margin height ratio and Cobb angle between the two groups(P>0.05).Compared with PKP group,VAS decreased more significantly in PVP group from 1 week to 12 months after surgery(P<0.05),and ODI decreased more significantly in PVP group from 1 month to 24 months after surgery(P<0.05),while there was no significant difference in other indexes between the two groups(P>0.05).Compared with the PVP group,the proportion of bone cement leakage was lower in the PKP group(P<0.05),and there was no significant difference in the incidence of new vertebral fractures and total vertebral fractures between the two groups(P>0.05).Conclusion PKP is superior to PVP in the treatment of osteoporotic vertebral compression fracture with spinal canal stenosis.The PKP surgical plan is reflected in the lower VAS,ODI and bone cement leakage after surgery.The short-and long-term effects of PKP are good.