| 周才盛,郑德攀,张国如.经皮椎体成形术和经皮后凸成形术治疗胸腰段骨质疏松性椎体压缩性骨折伴远隔部位疼痛的比较研究[J].安徽医药,2025,29(11):2295-2298. |
| 经皮椎体成形术和经皮后凸成形术治疗胸腰段骨质疏松性椎体压缩性骨折伴远隔部位疼痛的比较研究 |
| Comparative study of percutaneous vertebroplasty and percutaneous kyphoplasty for thoracolumbar osteoporotic vertebral compression fractures with remote pain |
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| DOI：10.3969/j.issn.1009-6469.2025.11.038 |
| 中文关键词: 骨质疏松性骨折 骨折，压缩性 椎体成形术 椎体后凸成形术 远隔部位疼痛 视觉模拟评分法 Oswestry功能障碍指数 |
| 英文关键词: Osteoporotic fractures Fractures, compression Vertebroplasty Kyphoplasty Distant pain Visual analog scale Oswestry disability index |
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| 中文摘要: |
| 目的比较经皮椎体成形术( PVP)和经皮后凸成形术( PKP)治疗胸腰段骨质疏松性椎体压缩性骨折( OVCF)伴远隔部位疼痛的临床疗效和影像学结果。方法回顾性分析 2018年 1月至 2021年 1月三亚中心医院(海南省第三人民医院)采用椎体增强术治疗 OVCF伴远隔部位疼痛 78例的病例资料，并根据手术方式分为 PVP组( 45例)和 PKP组( 33例)。分别于术前、后 2d、末次随访时采用视觉模拟评分法( VAS)和 Oswestry功能障碍指数( ODI)评估骨折椎体局部与远隔部位疼痛的严重程度术和功能障碍情况并比较，并在 X线片上测量患椎的椎体前高度( AVH)和局部后凸 Cobb角并比较。 PVP组随访时间为( 19.53±8.31)个月， PKP组随访时间为( 20.24±9.22)个月。结果两组病人术后 2d和末次随访时患椎局部疼痛 VAS评分、远隔部位疼痛 VAS评分和 ODI均较术前明显改善( P<0.05)但两组间相比却差异无统计学意义( P>0.05)。术前 PKP组与 PVP组 AVH和局部后凸 Cobb角差异无统计学意义( P>0.05)两组术后 2d、末次随访 AVH和局部后凸 Cobb角均较术前明显改善( P<0.05)；但 PKP组术后 2 d AVH［( 81.6±4.3)%比( 71.3±41)%］和局部后凸 Cobb角［( 9.3±2.9)°比( 14.5±2.3)°］、末次随访 AVH［( 80.5±3.9)%比( 69.9±4.5)%］和局部后凸 Cobb角［( 9.1±2.3)°比( 14.2±2.1)°］改善效果均明显优于 PVP组( P<0.05)。结论 PVP和 PKP均能有效缓解胸腰段 OVCF伴随的远隔部位疼痛，但 PKP在恢复 AVH和局部后凸 Cobb角方面优于 PVP。 |
| 英文摘要: |
| Objective To compare the clinical efficacy and imaging outcomes of percutaneous vertebroplasty (PVP) and percutaneouskyphoplasty (PKP) in treating thoracolumbar osteoporotic vertebral compression fracture (OVCF) with remote pain.Methods We retro-spectively analyzed medical records of 78 patients with OVCF and remote pain treated with vertebral augmentation at Sanya CentralHospital (Hainan Third People's Hospital) from August 2017 to August 2019. Patients were divided into PVP group (45 cases) and PKPgroup (33 cases) according to surgical approach. The visual analog scale (VAS) and Oswestry disability index (ODI) were used to assesslocal and remote pain severity and functional disability preoperatively, at 2 days postoperatively, and at final follow-up. Anterior verte-bral height (AVH) and local kyphotic Cobb angle were measured on radiographs. The mean follow-up duration (19.5±8.3) months in the PVP group and (20.2±9.2) months in the PKP group. Results Both groups showed significant improvement in VAS score for localpain, VAS score for remote pain, and ODI scores at 2 days postoperatively and final follow-up compared to preoperative values (P< 0.05), with no significant differences between groups (P>0.05). No significant differences in AVH and local kyphotic Cobb angle were observed between groups preoperatively (P>0.05). Both groups demonstrated significant improvement in AVH and local kyphotic Cobbangle at 2 days postoperatively and final follow-up compared to preoperative measurements (P<0.05). However, the PKP group showed significantly better improvement in AVH [(81.6±4.3)% vs. (71.3±4.1)%] and local kyphotic Cobb angle [(9.3±2.9)° vs. (14.5±2.3)°] at 2 days postoperatively, as well as in AVH [(80.5±3.9)% vs. (69.9±4.5)%] and local kyphotic Cobb angle [(9.1±2.3)° vs. (14.2±2.1)°] at fi-nal follow-up compared to the PVP group (P<0.05).Conclusion Both PVP and PKP effectively relieve romote pain associated withthoracolumbar OVCF, but PKP demonstrates superior efficacy in restoring anterior vertebral height and correcting local kyphosis com-pared to PVP. |
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