高粘度骨水泥椎体成形术与后凸成形术治疗骨质疏松椎体压缩骨折的比较

摘要

目的 比较高粘度骨水泥经皮椎体成形术(PVP)与低粘度骨水泥经皮后椎体凸成形术(PKP)治疗骨质疏松椎体压缩骨折的临床疗效.方法 2014年5月至2015年5月骨质疏松椎体压缩骨折患者128例,根据手术方法不同,随机分为高粘度PVP组(采用高粘度骨水泥, 64例)和PKP组(采用低粘度骨水泥,64例).评估两组患者腰痛、Oswestry功能障碍指数(ODI)、骨水泥渗漏率及椎体高度恢复率.结果 排除失访(高粘度PVP组3例,PKP组2例)及死亡(高粘度PVP组1例,PKP组2例)者,共120例患者纳入最终分析(高粘度PVP组60例, PKP组60例).两组患者年龄、性别、体重指数、椎体节段分布、术前VAS、ODI等一般资料比较,差异无统计学意义(P>0.05),具有可比性.两组患者术后腰痛VAS评分及ODI均较术前明显改善(P0.05);高粘度PVP组术后平均椎体高度恢复率为(29.8±11.6)%,明显低于PKP组的(41.7±19.8)%(P0.05). The low back pain and ODI in all patients had significant improvement as compared with the preoperative status(P0.05). The rate of vertebral height recovery was 29.8±11.6% in the high-viscosity group, which was significantly lower than that in the PKP group(41.7±19.8%)(P<0.05). Conclusions Both high-viscosity cement PVP and low-viscosity cement PKP,can quickly relieve pain of patients with osteoporotic vertebral compression fractures,improve spinal function,and have a similar incidence of cement leakage,however,PKP is superior to high viscosity PVP in postoperative vertebral height recovery.