实用医学杂志 ›› 2022, Vol. 38 ›› Issue (5): 600-605.doi: 10.3969/j.issn.1006⁃5725.2022.05.015

• 临床研究 • 上一篇    下一篇

经皮椎体后凸成形术与经皮椎体成形术治疗胸椎骨质疏松性骨折伴肋间痛的疗效比较

巩陈1 申才良2 吴建明1   

  1. 1 亳州市人民医院脊柱外科(安徽亳州 236800);2 安徽医科大学第一附属医院骨科(合肥 230022)

  • 出版日期:2022-03-10 发布日期:2022-03-10
  • 基金资助:
    亳州市人民医院院级科研课题资助(编号:By202013);安徽省重点研究与开发计划项目资助(编号:202104j07020053)

The efficacy of percutaneous kyphoplasty versus that of percutaneous vertebroplasty in the treatment of thoracic osteoporotic fractures with intercostal pain

GONG Chen*,SHEN Cailiang,WU Jianming.   

  1. Depart⁃ ment of Spine Surgery,Bozhou People′s Hospital,Bozhou 236800,China

  • Online:2022-03-10 Published:2022-03-10

摘要:

目的 对比经皮椎体后凸成形术(PKP)和经皮椎体成形术(PVP)治疗骨质疏松性胸椎骨 折(OVCFs)伴肋间痛的疗效。方法 选取本院 2020 6 月至 2021 2 月收治的胸椎 OVCFs 伴肋间痛患 者共 86 例,随机分为两组,PKP 组:采用体位复位后 PKP 治疗,PVP 组:单纯采用 PVP 治疗,随访 6 个月。 记录两组手术时间、住院时间、骨水泥注入量、伤椎前缘高度比、伤椎后凸角、VAS 评分、ODI 评分和并 发症。结果 两组术后肋间痛及胸背部痛 VAS 评分均较术前显著改善,差异有统计学意义(P < 0.05)。 两组术后 ODI 均较术前显著改善,差异有统计学意义(P < 0.05)。在伤椎前缘高度比及后凸角度方 面,PKP 组术后均较术前显著改善,差异有统计学意义(P < 0.05),而 PVP 组术后均较术前有改善,差异 无统计学意义(P > 0.05)。两组间在手术时间、住院时间、VAS 评分和 ODI 评分方面差异无统计学意义。 PKP 组在骨水泥注入量、骨水泥渗漏、伤椎前缘高度比和伤椎后凸角方面优于 PVP 组。结论 体位复 位后 PKP 和单纯 PVP 均能有效治疗胸椎 OVCFs 伴肋间痛,前者在骨水泥渗漏、伤椎高度恢复和后凸角 度恢复方面明显优于后者。

关键词:

经皮椎体后凸成形术, 经皮椎体成形术, 肋间痛, 骨质疏松, 胸椎骨折

Abstract:

Objective To compare the efficacy of percutaneous kyphoplasty(PKP)with that of percutaneous vertebroplasty(PVP)in the treatment of osteoporotic thoracic vertebral fractures with intercostal pain. Methods A total of 86 patients with thoracic OVCFs and intercostal pain,who had admitted to our hospital from January 2020 to February 2021,were selected and randomly divided into two groups. The PKP group received PKP after postural reduction,while the PVP group underwent PVP alone. Both groups were followed up for 6 months. Surgical duration,length of hospital stay,bone cement injection volume,height ratio of the anterior edge of the impaired vertebrae,kyphotic angle,VAS score,ODI score,and related complications were recorded in the two groups. Results The VAS scores of postoperative intercostal pain and chest and back pain in both groups were significantly improved as compared with the baselines,and the difference was statistically significant(P < 0.05). The postoper⁃ ative ODI in both groups was significantly improved as compared with the baseline,and the difference was statisti⁃ cally significant(P < 0.05). The height ratio of the anterior edge of the impaired vertebrae and the kyphotic angle were significantly improved in the PKP group after the procedure,and the difference was statistically significant (P < 0.05);while the PVP group was improved after the procedure,and the difference was not statistically signifi⁃ cant(P > 0.05). There were no significant statistical differences between the two groups in surgical duration,length of hospital stay,VAS score and ODI score. The PKP group was better than the PVP group in bone cement injection volume,bone cement leakage,height ratio of the anterior edge of the impaired vertebra,and kyphotic angle of the impaired vertebra. Conclusions Both PKP following postural reduction and PVP alone can effectively treat thoracic OVCFs with intercostal pain. The former is significantly better than the latter in bone cement leakage and recovery of impaired vertebral height and kyphotic angle.

Key words: percutaneous kyphoplasty,  , percutaneous vertebroplasty,  , intercostal pain,  , osteoporosis,  , thoracic vertebral fracture