DKP与BKP治疗骨质疏松性椎体压缩骨折的临床对比研究
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江苏大学医学临床科技发展基金(JLY20120154)


A comparison study between Jack vertebral dilator-kyphoplasty and balloon-kyphoplasty in the treatment of osteoporotic vertebral compression fractures
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    摘要:

    目的:比较Jack椎体扩张器后凸成形术(Jack vertebral dilator-kyphoplasty,DKP)与球囊扩张后凸成形术(balloon-kyphoplasty,BKP)治疗骨质疏松性椎体压缩骨折的临床疗效。方法:回顾性研究2010年1月至2012年12月共56例单个椎体老年骨质疏松性椎体压缩骨折患者,其中33例患者行DKP手术治疗,23例患者行BKP手术治疗,比较两组手术时间-术中出血量-骨水泥注入量-视觉疼痛模拟评分(visual analogue scales,VAS)和Oswestry功能障碍指数(Oswestry disability index,ODI),观察骨水泥在椎体内的分布情况,测量手术前后病椎高度和Cobb角的改变。结果:56例患者均获随访,其中DKP组随访7~16个月,平均10.7个月;BKP组随访6~15个月,平均9.5个月。两组手术时间-出血量-骨水泥注入量相比,差异均无统计学意义(P >0.05),两组术后椎体高度-后凸Cobb角-疼痛VAS评分及ODI评分均较术前改善(P < 0.05),DKP组在恢复椎体前缘高度和矫正后凸Cobb角方面优于BKP组(P < 0.05)。DKP组出现1例椎体旁骨水泥少量渗漏(3.0%);BKP组出现5例渗漏(21.7%),均无临床症状。结论:DKP和BKP均可有效治疗老年骨质疏松性椎体压缩骨折,DKP在恢复椎体前缘高度及矫正后凸Cobb角上效果更显著,且骨水泥的渗漏率更低。

    Abstract:

    Objective:To compare the clinical outcomes of Jack vertebral dilator-kyphoplasty (DKP)and balloon kyphoplasty(BKP)in treatment of osteoporotic vertebral compression fractures (OVCF). Methods:A retrospective study was conducted about 56 single OVCF cases from January 2010 to December 2012. Thirty-three cases were treated with DKP,while other 23 cases were treated with BKP procedures.The operating time,bleeding volume,cement injected volume were recorded during operation. The patients’ visual analogue scales (VAS)score and Oswestry disability index (ODI)score were also evaluated. The distribution of cement,the restoration of vertebral height and Cobb angle were also observed post-operation. Results:There were no significant differences in operating time,bleeding volume and cement injected volume between two groups (P > 0.05). The vertebral height,Cobb angle,VAS and ODI scores were significantly improved by those two operations (P < 0.05). The height of the anterior vertebrae and Cobb angle in DKP groups were restored more significantly than that of BKP group (P < 0.05). Cement leakages happened in one case (3.0%)in DKP group and in 5 cases (21.7%)in BKP group. Conclusion:DKP and BKP were both effective and safe for the treatment of OVCF. The height of anterior vertebrae and Cobb angle in DKP group were restored significantly than those in BKP groups,and there is lower cement leakage rate in DKP than that of BKP.

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卞元健,李大鹏,孙继芾,黄永辉,束浩明,付海祥. DKP与BKP治疗骨质疏松性椎体压缩骨折的临床对比研究[J].南京医科大学学报(自然科学版),2015,(8):1136-1141

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  • 收稿日期:2014-12-27
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  • 在线发布日期: 2015-08-04
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