中国组织工程研究

中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (18): 2851-2855.doi: 10.3969/j.issn.2095-4344.3806

• 脊柱植入物 spinal implant • 上一篇    下一篇

椎体后凸成形与椎体成形治疗老年骨质疏松性椎体压缩骨折：椎体高度恢复的比较

孙亦强1，邢建强1，李雪城1，王  欣1，田胜兰2，赵子豪1，耿晓鹏1    

  1. 1滨州医学院附属医院脊柱外科，山东省滨州市   256603；2滨州医学院，山东省烟台市   264003
  • 收稿日期:2020-06-02 修回日期:2020-06-05 接受日期:2020-06-19 出版日期:2021-06-28 发布日期:2021-01-12
  • 通讯作者: 耿晓鹏，博士，副教授，滨州医学院附属医院脊柱外科，山东省滨州市 256603
  • 作者简介:孙亦强，男，1993年生，山东省滨州市人，汉族，滨州医学院在读硕士，主要从事脊柱外科研究。

Kyphoplasty versus vertebroplasty in the treatment of osteoporotic vertebral compression fracture in the elderly: a comparison of vertebral height recovery

Sun Yiqiang1, Xing Jianqiang1, Li Xuecheng1, Wang Xin1, Tian Shenglan2, Zhao Zihao1, Geng Xiaopeng1   

  1. 1Department of Spinal Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China; 2Binzhou Medical University, Yantai 264003, Shandong Province, China
  • Received:2020-06-02 Revised:2020-06-05 Accepted:2020-06-19 Online:2021-06-28 Published:2021-01-12
  • Contact: Geng Xiaopeng, MD, Associate professor, Department of Spinal Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China
  • About author:Sun Yiqiang, Master candidate, Department of Spinal Surgery, Binzhou Medical University Hospital, Binzhou 256603, Shandong Province, China

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摘要：

文题释义：
椎体后凸成形：是在椎体成形基础上发展的新型微创技术，术中通过特制通道将可膨胀球囊置入病变椎体后对椎体进行撑开复位，恢复椎体高度和稳定性。现在主流观点认为椎体后凸成形在恢复椎体高度、矫正后凸畸形方面优于椎体成形。
Oswestry功能障碍指数：是一种国外骨科杂志常用于评价腰痛功能障碍的量表，由10个问题组成，包括疼痛的强度、生活自理、提物、步行、坐位、站立、干扰睡眠、性生活、社会生活、旅游等10个方面的情况，每个问题6个选项，每个问题的最高得分为5分，选择第一个选项得分为0分，依次选择最后一个选项得分为5分，得分越高表明功能障碍越严重。

背景：经皮椎体后凸成形和椎体成形为骨质疏松性椎体压缩骨折的主要微创治疗方法，然而选择二者哪一种作为最佳治疗措施仍存在争议。
目的：前瞻性研究经皮椎体后凸成形治疗单节段骨质疏松性椎体压缩骨折时恢复椎体高度的有效性。
方法：选择2017年1月至2018年12月86例单节段骨质疏松性椎体压缩骨折患者，按随机数字法分2组，分别进行椎体后凸成形骨水泥注射治疗与椎体成形骨水泥注射治疗，每组43例。比较两组手术前后的目测类比评分、Oswestry功能障碍指数评分、椎体高度恢复与Cobb角变化。试验已通过滨州医学院附属医院伦理委员会批准。
结果与结论：①两组术后3 d的目测类比评分、Oswestry功能障碍指数评分均低于术前(P < 0.05)，两组间比较差异无显著性意义(P > 0.05)；②两组术后3 d的伤椎高度与Cobb角均较术前明显改善(P < 0.05)，两组间比较差异无显著性意义(P > 0.05)；③椎体后凸成形组伤椎高度在球囊撑开后较术前增加(P < 0.05)，球囊撤出后伤椎高度出现丢失，并且低于球囊撑起时高度(P < 0.05)；④结果表明，椎体后凸成形和椎体成形均能有效缓解骨质疏松性骨折患者的疼痛，改善其日常生活功能，两种方法在恢复伤椎高度、减少后凸畸形上无明显差异。
https://orcid.org/0000-0002-4196-424X (孙亦强)

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 骨, 材料, 椎体成形, 椎体后凸成形, 骨水泥, 骨质疏松, 椎体压缩骨折, 椎体高度

Abstract: BACKGROUND: Percutaneous kyphoplasty and vertebroplasty are the main minimally invasive treatment methods for osteoporotic vertebral compression fracture, but which one is the best treatment method is still controversial.   
OBJECTIVE: To prospectively research the efficacy of percutaneous kyphoplasty in the treatment of single-segment osteoporotic vertebral compression fracture in restoring vertebral height. 
METHODS: From January 2017 to December 2018, 86 patients with single-segment osteoporotic vertebral compression fracture were included into this study and divided into two groups (n=43) by random number for percutaneous kyphoplasty and percutaneous vertebroplasty, respectively. Visual analogue scale, Oswestry disability index, vertebral height recovery and Cobb angle change were compared between the two groups. This trial was approved by the Ethics Committee of Binzhou Medical University Hospital. 
RESULTS AND CONCLUSION: (1) Visual analogue scale scores and Oswestry disability index in the two groups were significantly reduced at postoperative 3 days compared with those before operation (P < 0.05), but there was no statistically difference between the two groups (P > 0.05). (2) The height and Cobb angle of the involved vertebrae in the two groups were significantly improved at 3 days after operation compared with those before operation (P < 0.05), but there was no statistical difference between the two groups (P > 0.05). (3) The vertebral height of percutaneous kyphoplasty group increased after balloon distraction compared with that before surgery (P < 0.05), but the vertebral height was decreased after the balloon was removed and was lower than when the balloon was expanded (P < 0.05). (4) Results indicate that both percutaneous kyphoplasty and percutaneous vertebroplasty can effectively relieve the pain of patients with osteoporotic fractures and improved their daily life functions. There is no significant difference between the two methods in restoring vertebral height and reducing kyphosis of the involved vertebrae. 

Key words: bone, material, vertebroplasty, kyphoplasty, bone cement, osteoporosis, vertebral compression fracture, vertebral height

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