CAJ | 학술논문

目的：比较球囊扩张器与Jack扩张器治疗骨质疏松椎体压缩骨折的临床疗效。方法回顾分析2004年10月至2012年12月骨质疏松椎体压缩骨折行椎体后凸成形术患者共179例(190椎)，根据术中使用的扩张器分为BKP组(球囊扩张器)和DKP组(Jack扩张器)，其中BKP组90例(96椎)、DKP组89例(94椎)。各组再按Easetllla分类方法分为凹陷组、楔形组和扁平组。记录各组患者的手术时间、术中出血量、骨水注射量，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、出血量差异无统计学意义(P>0.05)；楔形组注入骨水泥的量DKP组为(5.7±0.5) ml，与BKP组的(4.02±1.1) ml比较差异有统计学意义(P<0.05)。BKP组和DKP组两组之间的楔形组患者术后疼痛VAS评分、ODI评分、椎体前缘、中部高度和Cobb角比较，差异有统计学意义(P<0.05)。结论 DKP对于椎体楔形压缩骨折在恢复椎体前缘、中部高度、手术前后后凸Cobb角及ODI评分恢复方面均优于BKP。
목적：비교구낭확장기여Jack확장기치료골질소송추체압축골절적림상료효。방법회고분석2004년10월지2012년12월골질소송추체압축골절행추체후철성형술환자공179례(190추)，근거술중사용적확장기분위BKP조(구낭확장기)화DKP조(Jack확장기)，기중BKP조90례(96추)、DKP조89례(94추)。각조재안Easetllla분류방법분위요함조、설형조화편평조。기록각조환자적수술시간、술중출혈량、골수주사량，관찰수술전、후동통시각모의법(VAS)평분화Oswestry공능장애지수(ODI)평분정황，측상추전、중부고도화Cobb각개변。결과소유환자균안전완성수술。이매개추체계산，량조환자적수술시간、출혈량차이무통계학의의(P>0.05)；설형조주입골수니적량DKP조위(5.7±0.5) ml，여BKP조적(4.02±1.1) ml비교차이유통계학의의(P<0.05)。BKP조화DKP조량조지간적설형조환자술후동통VAS평분、ODI평분、추체전연、중부고도화Cobb각비교，차이유통계학의의(P<0.05)。결론 DKP대우추체설형압축골절재회복추체전연、중부고도、수술전후후철Cobb각급ODI평분회복방면균우우BKP。
Objective To compare the clinical outcome of balloon-kyphoplasty and dilator-kyphoplasty in the treatment of osteoporosis vertebral compression fracture. Methods One hundred and seventy-nine patients (190 vertebrae) with osteoporosis compression fractures were treated by kyphoplasty from October 2004 to December 2012. All patients were divided into balloon-kyphoplasty (BKP) group (balloon dilator, 90 cases, 96 vertebrae) and di-lator-kyphoplasty (DKP) group (Jack dilator, 89 cases, 94 vertebrae) according to the dilator used in operation. Each group were then divided into three subgroups (depression subgroup, wedge-shaped subgroup, flat subgroup) based on Easetllla classification. The operation time, blood loss, and the amount of bone cement injection were recorded during operation. The amount of cement, the restoration of vertebral height and Cobb angle were observed. The patients' visu-al Analogue Score (VAS) and Oswestry Disability Index (ODI score) were evaluated after operation. Results There were no differences in operation time, bleeding volume of every vertebrae between two groups (P>0.05). The average amount of bone cement introduced per vertebra was (5.7 ± 0.5) ml injected by DKP and (4.02 ± 1.1) ml by BKP in the wedge-shaped subgroup (P<0.05). The change after operation of VAS and ODI scores, anterior border and central height of vertebrae and Cobb angle had statistically significantly differences (P<0.05) in the wedge-shaped subgroup. Conclusion The change of ODI score and correction of kyphotic deformity and restoration of the anterior vertebral body heights associated with osteoporotic vertebral compression fractures are better treated by DKP in the wedge-shaped subgroup.