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PVP与PKP治疗无神经损害症状的老年人胸腰椎骨折不愈合疗效比较
PVP versus PKP for treatment of non-union of thoracolumbar vertebral fractures in the elderly without nerve injury
  
DOI:
中文关键词:  椎体  骨折不愈合  椎体成形术  后凸椎体成形术
英文关键词:Vertebrae  Non-union fracture  Vertebroplasty  Kyphoplasty
基金项目:
作者单位
徐用亿 季峰* 王守国 费昊东 孙进  
通讯作者:徐用亿 季峰* 王守国 费昊东 孙进    
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中文摘要:
      目的 比较分析PVP与PKP治疗单节段无神经损害症状的老年人胸腰椎骨折不愈合的临床疗效。方法 选择2013年1月至2019年1月期间南京医科大学附属淮安第一医院治疗的38例单节段无神经损害症状的老年人胸腰骨折不愈合患者。其中,男16例,女22例,年龄68 ~ 92岁,分为PVP组(n=21)和PKP组(n=17)。比较两组的手术时间、住院费用,比较两组术前、术后末次随访时的腰背痛VAS评分、ODI评分、椎体高度和受累椎体后凸角等,比较两组的骨水泥使用量和骨水泥渗漏率。结果 PVP组的手术时间(36.09±7.43)min比PKP组手术时间(43.29±5.97)min短,且PVP组住院费用(20 427.57±1 724.31)元比PKP组住院费用(28 798.53±1 983.94)元低(P<0.05)。所有病例随访12 ~ 18个月,术前、术后的VAS评分、ODI评分、椎体前缘高度、椎体中线高度以及受累椎体后凸角,各自组内比较差异具有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。两组骨水泥注入量及骨水泥渗漏率比较,差异无统计学意义(P>0.05)。结论 采用PVP与PKP治疗无神经损害症状的老年人胸腰椎骨折不愈合均能取得令人满意的临床疗效,前者较后者手术时间短、住院费用低。
英文摘要:
      Objective To compare the clinical outcomes of PVP versus PKP for treatment of nonunion of thoracolumbar vertebral fractures in the elderly without nerve injury. Methods From January 2013 to January 2019, 38 patients with single nonunion of vertebral fracture without nerve deficit treated at the Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University were divided into PVP group (n=21) and PKP group (n=17), which consisted of 16 males and 22 females, with age ranging from 68 to 92 years. The operative time, cost of hospitalization, visual analogue scale (VAS) for back pain, Oswestry disability index (ODI) scores, height of diseased vertebrae and segmental Cobb' s angle were applied for evaluation of the consequences.The usage of bone cement and the leakage rate of bone cement were also compared between the two groups. Results There were significant differences between the two groups in operative time [(36.09±7.43) min versus (43.29±5.97) min] and cost of hospitalization [(20 427.57±1 724.31) yuan versus (28 798.53±1 983.94) yuan](P<0.05). All 38 patients were followed up for 12 to 18 months.There were significant differences in preoperative and postoperative VAS score, ODI score, anterior height of vertebral body, midline height of vertebral body and kyphosis angle of affected vertebral body within the groups (P<0.05), but there was no significant difference between the two groups (P>0.05). There was no significant difference in the amount of bone cement injected between the two groups (P>0.05), and there was no significant difference in the leakage rate of bone cement between the two groups (P>0.05). Conclusion PVP and PKP had similar and satisfactory clinical outcomes in treatment of non-union of thoracolumbar fractures in the elderly without nerve injury, but the operative time and cost of hospitalization of the former were shorter and lower than the latter.
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