CAJ | 학술논문

目的：比较研究经皮椎体后凸成形术（PKP）与经皮椎体成形术（PVP）治疗骨质疏松性胸腰段椎体骨折的临床疗效。方法回顾性分析2009年3月至2012年10月间治疗的53例病患资料，分为 PKP（32例）及 PVP（21例）两种治疗组。比较两组单椎体手术操作时间、X 线暴露时间、骨水泥注射量、渗漏情况、椎体压缩率、Cobb 角、疼痛视觉模拟评分（VAS）评分和功能障碍指数（ODI）评分。结果患者均顺利完成手术，术后随访15~26个月，平均18.2个月。PKP 组较 PVP 组单椎体手术操作时间、X 线暴露时间和骨水泥注射量显著提高。PKP 组术后和随访时椎体压缩率及 Cobb 角无统计学差异，但较术前明显改善。PVP 组术前、术后和随访时椎体压缩率及 Cobb 角无明显变化。术后 PKP组压缩率及 Cobb 角的改善效果优于 PVP 组。PKP 组发生2例骨水泥渗漏，PVP 组发生3例骨水泥渗漏，两组发生渗漏的患者均无神经症状。PKP 与 PVP 组患者术后及随访时的 VAS、ODI 评分差异无统计学意义，但均较术前明显改善。结论 PKP 及 PVP 均是临床治疗骨质疏松性胸腰段骨折的有效手段，两者均能改善临床症状，而 PKP 在恢复椎体高度、后凸畸形及减少骨水泥外渗方面较优。
목적：비교연구경피추체후철성형술（PKP）여경피추체성형술（PVP）치료골질소송성흉요단추체골절적림상료효。방법회고성분석2009년3월지2012년10월간치료적53례병환자료，분위 PKP（32례）급 PVP（21례）량충치료조。비교량조단추체수술조작시간、X 선폭로시간、골수니주사량、삼루정황、추체압축솔、Cobb 각、동통시각모의평분（VAS）평분화공능장애지수（ODI）평분。결과환자균순리완성수술，술후수방15~26개월，평균18.2개월。PKP 조교 PVP 조단추체수술조작시간、X 선폭로시간화골수니주사량현저제고。PKP 조술후화수방시추체압축솔급 Cobb 각무통계학차이，단교술전명현개선。PVP 조술전、술후화수방시추체압축솔급 Cobb 각무명현변화。술후 PKP조압축솔급 Cobb 각적개선효과우우 PVP 조。PKP 조발생2례골수니삼루，PVP 조발생3례골수니삼루，량조발생삼루적환자균무신경증상。PKP 여 PVP 조환자술후급수방시적 VAS、ODI 평분차이무통계학의의，단균교술전명현개선。결론 PKP 급 PVP 균시림상치료골질소송성흉요단골절적유효수단，량자균능개선림상증상，이 PKP 재회복추체고도、후철기형급감소골수니외삼방면교우。
Objective To compare the clinical effect of percutaneous kyphoplasty(PKP)and percutaneous(PVP)vertebraplasty in the treatment of osteoporotic thoracolumbar fracture. Methods 53 patients were treated with PKP(32 patients)or PVP(21 patients)in our hospital from March 2009 to October 2012. The operation time,X - ray exposure time,injection dose and leakage occurrence were compared between these two groups. The vertebral compression rate and the Cobb angle were evaluated by X - ray. The VAS and ODI scoring systems were employed to compare the pain and quality of life respectively in each group. Results All operations were plain sailing. The average follow - up period was 18. 2(15 ~ 26)months. The PKP group had a much longer operation and X - ray exposure time than PVP group,but also did injection dose. The vertebral compression rate and the Cobb angle after PKP showed no statistical difference in comparison with those in follow - up,which were better than those of before operation. And for PVP group,there were no significant differences of the vertebral compression rate and the Cobb angle be-tween preoperation and postoperation. Two leakage cases occurred in PKP and three in PVP without neurological deficiency. The VAS or ODI scores after operation presented no significant difference in comparison with those in follow - up between PKP and PVP group,but which were bet-ter than those before operation. The vertebral compression rate and the Cobb angle in the PKP group were better than that in the PVP group. Con-clusion In the treatment of osteoporotic thoracolumbar fracture,PKP and PVP are both the effective surgical techniques to improve the clinical symptom. However,PKP is superior to PVP on the recovery of the vertebral body height and kyphosis after PKP is superior to those after PVP,and also in the reduction of the injective leakage rate.