Objective To evaluate the effect of CT and C arm fluoroscopy in the PKP operation on osteoporotic vertebral compression fractures (OVCF). Methods From July 2014 to July 2015, 80 patients with OVCF were treated with PKP. The patients were randomly divided into two groups according to the random number table method. The observation group (40 cases) was given CT positioning and guided PKP operation. The control group (40 cases) was guided by C arm X-ray fluoroscopy. At preoperation, postoperative 7 d, 1 year and the last follow-up, the relative efficacy indicators were compared between the two groups. Results Compared with before surgery, postoperative VAS score, ODI index and Cobb angle of kyphosis in two groups were significantly decreased (P＜0.05), the anterior vertebral relative height was significantly increased (P＜0.05); but compared with the control group, the improvement of the observation group was more significant (P＜0.05). In the observation group, 1 case of bone cement leakage occurred during follow-up (2.5%), adjacent segment fractures in 4 cases (10%), which were significantly lower than those in the control group (7 case,17.5% and 9 cases, 22.5%), the differences were statistically significant (P＜0.05). Conclusion The two guiding methods for PKP surgery can achieve good curative effect, but under the guidance of CT, PKP can significantly improve the operation accuracy, reduce the incidence of complications.%目的 在骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)行PKP手术操作中,探讨CT与C臂机X线透视引导的疗效是否有所差异.方法 自2014-07-2015-07收治80例OVCF患者,均予以PKP手术治疗.采用随机数字表法,将患者随机分为两组,其中观察组40例术中予以CT定位引导下PKP手术;对照组40例术中予以C臂机X线透视引导.分别于两组患者术前、术后7 d、1年和末次随访时,进行相关疗效指标的对比.结果 与术前相比,两组术后VAS评分、ODI指数和后凸Cobb角均显著降低(P＜0.05),伤椎前缘相对高度均显著提高(P＜0.05);但与对照组相比,观察组上述指标的改善情况更佳(P＜0.05).观察组发生骨水泥渗漏1例(2.5%),随访期间出现邻近节段骨折4例(10%),均显著少于对照组的7例(17.5%)和9例(22.5%),差异均有统计学意义(P＜0.05).结论 两种引导方式行PKP手术均可取得良好疗效;CT引导下可明显提高PKP手术的操作精确度,降低并发症发生率.
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