CAJ | 학술논문

目的比较椎体扩张器后凸成形术(DKP)与Sky骨膨胀器后凸成形术(EKP)治疗骨质疏松压缩骨折的临床疗效及优缺点.方法 2004年10月至2008年5月,对29例(29椎)骨质疏松压缩骨折患者行 DKP(DKP组),对22例(27椎)骨质疏松压缩骨折患者行EKP(EKP组).记录两组患者的手术时间、术中出血量、骨水泥注射量,观察手术前、后疼痛视觉模拟法(VAS)评分和Oswestry功能障碍指数(ODI)评分情况,测量伤椎前、中部高度和Cobb角改变.结果所有患者均安全完成手术.以每个椎体计算,两组患者的手术时间、出血量差异均无统计学意义(P>0.05);DKP组注入骨水泥的量[(5.7±0.5)mL]与EKP组[(3.6±1.6)mL]比较差异有统计学意义(P<0.05).两组患者术后疼痛VAS评分、ODI评分、椎体前缘、中部高度和Cobb角均较术前明显改善,差异有统计学意义(P<0.05).两组患者术后的ODI评分、椎体前缘、中部高度及Cobb角的改善度比较差异均有统计学意义(P<0.05).DKP组1例(1椎)出现椎体旁骨水泥少量渗漏(3.4%);EKP组9例(11椎)出现骨水泥渗漏(40.7%),均无临床症状.结论 DKP和EKP治疗疼痛性骨质疏松椎体压缩骨折均有良好的临床疗效,均可有效恢复椎体前缘、中部高度和Cobb角,DKP在椎体前缘、中部高度恢复及Cobb角矫正方面优于EKP,但骨水泥渗漏率较高.
목적 비교추체확장기후철성형술(DKP)여Sky골팽창기후철성형술(EKP)치료골질소송압축골절적림상료효급우결점.방법 2004년10월지2008년5월,대29례(29추)골질소송압축골절환자행 DKP(DKP조),대22례(27추)골질소송압축골절환자행EKP(EKP조).기록량조환자적수술시간、술중출혈량、골수니주사량,관찰수술전、후동통시각모의법(VAS)평분화Oswestry공능장애지수(ODI)평분정황,측량상추전、중부고도화Cobb각개변.결과 소유환자균안전완성수술.이매개추체계산,량조환자적수술시간、출혈량차이균무통계학의의(P>0.05);DKP조주입골수니적량[(5.7±0.5)mL]여EKP조[(3.6±1.6)mL]비교차이유통계학의의(P<0.05).량조환자술후동통VAS평분、ODI평분、추체전연、중부고도화Cobb각균교술전명현개선,차이유통계학의의(P<0.05).량조환자술후적ODI평분、추체전연、중부고도급Cobb각적개선도비교차이균유통계학의의(P<0.05).DKP조1례(1추)출현추체방골수니소량삼루(3.4%);EKP조9례(11추)출현골수니삼루(40.7%),균무림상증상.결론 DKP화EKP치료동통성골질소송추체압축골절균유량호적림상료효,균가유효회복추체전연、중부고도화Cobb각,DKP재추체전연、중부고도회복급Cobb각교정방면우우EKP,단골수니삼루솔교고.
Objective To compare the clinical results of dilator-kyphoplasty (DKP) and SKy-bone expander kyphoplasty (EKP) . Methods From October 2004 to May 2008, 51 patients with vertebral osteoporotic compression fracture received DKP (29 vertebras) and EKP (27 vertebras). The operation time,bleeding volume, cement injection volume were recorded during operation. The patients' visual analogue scale (VAS) and Oswestry disability index (ODI) scores were evaluated before and after operation. The cement distribution and restoration of vertebral height and Cobb angle were observed post-operation. Results There were no significant differences in operation time or bleeding volume at every vertebra between the 2 groups ( P > 0. 05). The DKP group had a significantly larger cement injection volume of (5.7 ±0. 5) mL than the EKP group [(3.6 ± 1.6) mL] ( P < 0.05). The VAS and ODI scores were decreased significantly in both groups after operation ( P < 0.05) . The vertebral height and Cobb angle were restored in both groups after operation. Nine cases ( 11 vertebras, 40. 7% ) had cement leakage in the EKP group, but one case (one vertebrae, 3.4% ) did in the DKP group. Conclusions Both DKP and EKP are efficacious and safe in the treatment of vertebral compression fractures. The vertebral anterior height, middle vertebral body height, and Cobb angle can be all restored by both procedures. DKP may be better in restoration of the vertebral anterior height, middle vertebral body height, and Cobb angle. DKP may lead to less cement leakage than EKP.