单侧横突外垂直和双侧经皮椎体后凸成形术治疗胸腰椎骨质疏松性椎体压缩骨折的临床效果比较

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2024-07-18 DOI:10.3389/fsurg.2024.1395289

Dingli Xu, Chaoyue Ruan, Yang Wang, Xudong Hu, Weihu Ma

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引用次数: 0

摘要

背景骨质疏松症椎体压缩性骨折（OVCF）是衰老过程中的常见病。本研究旨在比较单侧横突经外椎体成形术（UEPKP）和双侧经椎体经皮椎体成形术（BTPKP）对胸腰椎OVCF患者的治疗效果。方法研究了2019年5月至2021年4月期间在我院接受单水平PKP治疗的136例OVCF患者的数据。根据手术方法对患者进行分组：UEPKP 组有 62 名患者，BTPKP 组有 74 名患者。所有临床和放射学数据均来自病历。临床结果包括视觉模拟量表（VAS）、Oswestry 失能指数（ODI）和日本骨科协会（JOA）腰椎评分，分别在术前、术后和随访时进行评估。此外，还收集了放射学评估（椎体前缘高度率和局部后凸角度）和并发症。与 BTPKP 组相比，UEPKP 组患者的手术时间明显缩短，透视次数明显减少（p < 0.05）。然而，BTPKP 组患者的分布评分和骨水泥量明显更好（p&p;lt; 0.05）。在最后随访时，UEPKP 组的 VAS 评分（0.6 ± 0.5 vs. 0.9 ± 0.8）和 ODI（24.7 ± 3.1 vs. 27.5 ± 1.8）明显优于 BTPKP 组（p &p;lt;0.05）。在6个月和12个月的随访中，UEPKP组的放射学结果（前部高度率和局部驼背角）明显较差（p &;lt;0.05）。结论 UEPKP是胸腰椎骨质疏松性椎体压缩骨折患者的一种安全有效的替代手术，与BTPKP相比，它在减少椎间隙内漏和面关节侵犯方面具有明显优势。

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Comparison of the clinical effect of unilateral transverse process extrapedicular and bilateral transpedicular percutaneous kyphoplasty for thoracolumbar osteoporotic vertebral compression fracture

BackgroundOsteoporosis vertebral compression fractures (OVCF) are common with the aging process. This study aimed to compare the effects of unilateral transverse process extrapedicular (UEPKP) and bilateral transpedicular percutaneous kyphoplasty (BTPKP) for patients with thoracolumbar OVCF.MethodsData from 136 patients with OVCF treated with single-level PKP in our hospital between May 2019 and April 2021 were studied. Patients were grouped based on surgical procedure: there were 62 patients in the UEPKP group and 74 in the BTPKP group. All clinical and radiological data were collected from medical records. Clinical outcomes, including visual analog scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores of the lumbar spine, were evaluated preoperatively, postoperatively, and at the follow-up visit. The radiological evaluations (anterior vertebral height rate and local kyphosis angle) and complications were also collected.ResultsAll patients had successfully improved after surgery. In the UEPKP group, patients showed a significantly shorter operating time and lower fluoroscopy frequency than patients in the BTPKP group (p < 0.05). However, a significantly better distribution score and cement volume were found in the BTPKP group (p < 0.05). The UEPKP group achieved a significantly better VAS score (0.6 ± 0.5 vs. 0.9 ± 0.8) and ODI (24.7 ± 3.1 vs. 27.5 ± 1.8) at the final follow-up visit than the BTPKP group (p < 0.05). The UEPKP group showed significantly worse radiological outcomes (anterior height rate and local kyphosis angle) at the 6- and 12-month follow-ups (p < 0.05). As for complications, the UEPKP group showed significantly fewer facet joint violations and intraspinal leakages (p < 0.05).ConclusionUEPKP could be a safe and effective alternative procedure for patients with thoracolumbar osteoporotic vertebral compression fracture, which possesses an apparent advantage in reducing intraspinal leakage and facet joint violation over BTPKP.

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.