| 刘欢,王志强,徐颖.椎体成形术、椎体后凸成形术及弯角椎体成形术治疗陈旧性椎体骨折骨不连的临床疗效比较[J].安徽医药,2026,30(5):979-983. |
| 椎体成形术、椎体后凸成形术及弯角椎体成形术治疗陈旧性椎体骨折骨不连的临床疗效比较 |
| Comparison of clinical efficacies of PVP, PKP, and curved PVP in the treatment of Kümmell's disease |
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| DOI：10.3969/j.issn.1009-6469.2026.05.026 |
| 中文关键词: 脊柱骨折 骨折不愈合 椎体成形术 椎体后凸成形术 弯角装置 陈旧性椎体骨折骨不连 |
| 英文关键词: Spinal fractures Nonunion Percutaneous vertebroplasty Percutaneous kyphoplasty Corner bending device Kümmell's disease |
| 基金项目:邯郸市科学技术研究与发展计划项目( 21422083053) |
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| 中文摘要: |
| 目的对比椎体成形术( PVP)、椎体后凸成形术( PKP)及弯角 PVP治疗陈旧性椎体骨折骨不连( Kummell病)的临床疗效，为日后选择更有效的术式治疗该病提供指导。方法回顾性分析 2018年 3月至 2022年 7月邯郸市第一医院收治的 106例陈旧性椎体骨折骨不连病人的临床资料，按手术方式的不同分成 PVP组( n=35，应用 PVP治疗)、弯角 PVP组( n=36，应用弯角 PVP治疗)和 PKP组( n=35，应用 PKP治疗)。比较三组手术情况、 Cobb角、病椎相对高度、疼痛数字评估表( NRS)评分、 Oswestry功能障碍指数( ODI)、骨水泥分布、骨水泥渗漏情况及邻近椎体再骨折情况。结果 PVP组和弯角 PVP组手术用时［( 22.63±5.29)min、(23.81±5.47)min比( 34.54±6.08)min］、骨水泥用量［( 3.78±1.23)mL、(4.25±1.46)mL比( 6.02±1.85)mL］均少于 PKP组( P<0.05)而 PVP组和弯角 PVP组比较均差异无统计学意义( P>0.05)；术后 6个月，弯角 PVP组、 PKP组 Cobb角、 NRS评分、 ODI小于 PVP组，(P<0.05)而弯角 PVP组 Cobb角、病椎相对高度、 NRS评分及 ODI和 PKP组比较均差异无统计学意义(P>0.05)；弯角 PVP组、 PKP组骨水，泥分布情况较 PVP组优( P<0.05)骨水泥渗漏发生率较 PVP组低( P<0.05)，而弯角 PVP组骨水泥分布情况及骨水泥渗漏发生率和 PKP组比较差异无统计学意义(，P>0.05)；三组邻近椎体再骨折发生率比较差异无统计学意义( P>0.05)。结论 PKP与弯角 PVP可克服 PVP存在的骨水泥分布不均、易渗漏等问题，对陈旧性椎体骨折骨不连病人 Cobb角、疼痛、功能障碍的改善效果较 PVP更优。且弯角 PVP在减少手术耗时、骨水泥用量方面较 PKP更具优势。 |
| 英文摘要: |
| Objective To compare the clinical efficacies of percutaneous vertebroplasty (PVP), percutaneous kyphoplasty (PKP), andcurved PVP in the treatment of Kümmell's disease, providing guidance for selecting a more effective procedure for the treatment of thedisease in the future.Methods A retrospective analysis was conducted on the clinical data of 106 Kümmell disease patients admittedto The First Hospital of Handan from March 2018 to July 2022. They were grouped into PVP group (n=35, treated with PVP), curved PVP group (n=36, treated with curved PVP), and PKP group (n=35, treated with PKP) according to different surgical methods. The fol.lowing parameters were compared among the three groups: surgical data, Cobb angle, relative height of the diseased vertebrae, pain nu.merical rating scale (NRS) score, Oswestry dysfunction index (ODI), bone cement distribution, bone cement leakage, and adjacent verte.bral refracture.Results The surgical time [(22.63±5.29) min, (23.81±5.47) min vs. (34.54±6.08) min] and bone cement dosage [(3.78± 1.23) mL, (4.25±1.46) mL vs. (6.02±1.85) mL] in the PVP group and the curved PVP group were lower than those in the PKP group (P< 0.05), however, there was no statistically significant difference between the PVP group and the curved PVP group (P>0.05). At 6months after surgery, the Cobb angle, NRS score, and ODI in the curved PVP group and PKP group were lower than those in the PVPgroup (P<0.05). However, there were no statistically significant differences in Cobb angle, relative height of the diseased vertebra, NRSscore, and ODI between the curved PVP group and PKP group (P>0.05). The distribution of bone cement in the curved PVP group and PKP group was better than that in the PVP group (P<0.05), and the incidence of bone cement leakage was lower in two groups than that in the PVP group (P<0.05). However, there were no statistically significant differences in the distribution of bone cement and incidenceof bone cement leakage between the curved PVP group and the PKP group (P>0.05). There was no statistically significant difference in the incidence of adjacent vertebral refracture among the three groups (P>0.05).Conclusions PKP and curved PVP can overcome the problems of uneven distribution and high leakage risk of bone cement in PVP, and have a better improvement effect on Cobb angle, pain, and dysfunction in Kümmell disease patients than PVP. Additionally, curved PVP offers advantages over PKP in reduced surgical time and less bone cement usage. |
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