首页|经皮椎体后凸成形术与经皮椎体成形术治疗老年骨质疏松性椎体压缩性骨折患者的效果比较

经皮椎体后凸成形术与经皮椎体成形术治疗老年骨质疏松性椎体压缩性骨折患者的效果比较

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目的:比较经皮椎体后凸成形术(PKP)与经皮椎体成形术(PVP)治疗老年骨质疏松性椎体压缩性骨折(OVCF)患者的效果.方法:回顾性分析 2021 年 2 月至 2023 年 2 月该院收治的 60 例老年OVCF患者的临床资料,根据手术方法不同将其分为研究组和对照组各 30 例.对照组采用PVP治疗,研究组采用PKP治疗.比较两组手术相关指标(手术时间、术中出血量、术中X线照射次数、骨水泥用量),手术前后脊柱结构指标(Cobb角、伤椎前缘高度和椎体压缩率)、腰椎功能[Oswestry功能障碍指数(ODI)]评分,以及并发症发生率.结果:两组手术时间、术中出血量比较,差异均无统计学意义(P>0.05);研究组术中X线照射次数少于对照组,骨水泥用量多于对照组,差异均有统计学意义(P<0.05).术后7 d,两组Cobb角均小于术前,且研究组小于对照组,两组椎体压缩率均低于术前,且研究组低于对照组,两组伤椎前缘高度均大于术前,且研究组大于对照组,差异有统计学意义(P<0.05);术后 3 个月,两组ODI评分均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为6.67%(2/30),低于对照组的26.67%(8/30),差异有统计学意义(P<0.05).结论:与PVP相比,PKP治疗老年OVCF患者可减少术中X线照射次数,增加骨水泥用量和伤椎前缘高度,减小术后Cobb角,降低椎体压缩率、ODI评分和并发症发生率,且不增加手术时间和术中出血量.
Comparison of effects of percutaneous kyphoplasty and percutaneous vertebroplasty in treatment of elderly patients with osteoporotic vertebral compression fractures
Objective:To compare effects of percutaneous kyphoplasty(PKP)and percutaneous vertebroplasty(PVP)in treatment of elderly patients with osteoporotic vertebral compression fractures(OVCF).Methods:The clinical data of 60 elderly patients with OVCF admitted to this hospital from February 2021 to February 2023 were retrospectively analyzed.According to different surgical methods,they were divided into study group and control group,30 cases in each group.The control group was treated with PVP,while the study group was treated with PKP.The operation related indexes(operation time,intraoperative blood loss,intraoperative X-ray irradiation times,bone cement dosage)levels,the spinal structure indexes(Cobb angle,anterior vertebral height and vertebral compression rate)levels,the lumbar function[Oswestry dysfunction index(ODI)]score before and after the surgery,and the incidence of complications were compared between the two groups.Results:There were no significant differences in the operation time and the intraoperative blood loss between the two groups(P>0.05).The intraoperative X-ray irradiation times in the study group was less than that in the control group,the bone cement dosage was more than that in the control group,and the differences were statistically significant(P<0.05).Seven days after the surgery,the Cobb angle levels of the two groups were smaller than those before the surgery,and that of the study group was smaller than that of the control group the vertebral compression rates of the two groups were lower than those before the surgery,and that of the study group was than that of the control group;the anterior vertebral height of the injured vertebrae of the two groups were higher than those before the surgery,and that of the study group was higher than that of the control group;and the differences were statistically significant(P<0.05).Three months after surgery,the ODI scores of both groups were lower than those before surgery,and the ODI score in the study group was lower than that in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the study group was 6.67%(2/30),which was lower than 26.67%(8/30)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Compared with PVP,the PKP in the treatment of the elderly patients with OVCF can reduce the intraoperative X-ray irradiation times,increase the bone cement dosage and the anterior vertebral height of the injured vertebra,reduce the postoperative Cobb angle,the vertebral compression rate,ODI scores and the incidence of complications,and do not increase the operation time and the intraoperative blood loss.

Percutaneous kyphoplastyPercutaneous vertebroplastyOsteoporotic vertebral compression fracturesElderlySpinal fractureBalloon dilatation

梁广胜、吴鸿、熊力伟

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南昌市人民医院骨科,江西 南昌 330009

经皮椎体后凸成形术 经皮椎体成形术 骨质疏松性椎体压缩性骨折 老年 脊柱骨折 球囊扩张

2024

中国民康医学
中国社会工作协会

中国民康医学

影响因子:0.649
ISSN:1672-0369
年,卷(期):2024.36(16)
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