CAJ | 학술논문

目的：比较单、双侧椎弓根入路经皮球囊扩张椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩骨折（OVCF）临床疗效的差异。方法：2012年1月至2014年3月收治的56例骨质疏松胸腰椎单、双节段椎体压缩骨折患者被随机分为两组，分别采用单侧（29例33椎）与双侧（27例31椎）椎弓根入路填充聚甲基丙烯酸甲酯（PMMA）骨水泥修复伤椎。对两组患者的临床资料进行前瞻性分析，比较两组患者治疗效果的差异。结果：两组患者术后VAS评分、Beck值、后凸Cobb角及ODI指数均较术前有改善（P ＜0．01），但两组间比较差异无统计学意义（P ＞0．05）；单侧组平均手术时间、X线暴露时间、骨水泥填充量少于双侧组（P ＜0．01），两组术后骨水泥渗漏率、疼痛改善率及严重并发症发生率比较差异均无统计学意义（P ＞0．05）。结论：经皮球囊扩张PKP对OVCF病症具有明显改善作用，单、双侧椎体强化方式疗效相当，单侧具有操作步骤少、手术和X线暴露时间短、骨水泥填充量少等优势。
목적：비교단、쌍측추궁근입로경피구낭확장추체후철성형술（PKP）치료골질소송성추체압축골절（OVCF）림상료효적차이。방법：2012년1월지2014년3월수치적56례골질소송흉요추단、쌍절단추체압축골절환자피수궤분위량조，분별채용단측（29례33추）여쌍측（27례31추）추궁근입로전충취갑기병희산갑지（PMMA）골수니수복상추。대량조환자적림상자료진행전첨성분석，비교량조환자치료효과적차이。결과：량조환자술후VAS평분、Beck치、후철Cobb각급ODI지수균교술전유개선（P ＜0．01），단량조간비교차이무통계학의의（P ＞0．05）；단측조평균수술시간、X선폭로시간、골수니전충량소우쌍측조（P ＜0．01），량조술후골수니삼루솔、동통개선솔급엄중병발증발생솔비교차이균무통계학의의（P ＞0．05）。결론：경피구낭확장PKP대OVCF병증구유명현개선작용，단、쌍측추체강화방식료효상당，단측구유조작보취소、수술화X선폭로시간단、골수니전충량소등우세。
Objective To compare the clinical efficacy of percutaneous kyphoplasty (PKP) by balloon dilatation between unipedicular and bilateral pedicle approach for the treatment of osteoporotic vertebral compression fractures (OVCF). Methods From January 2012 to March 2014, 56 patients with single-level or double- level OVCF were randomly divided into two groups. 29 patients with 33 vertebral bodies were performed by PKP through unipedicular approach and 27 patients with 31 vertebral bodies through bipedicular approach , used PMMA bone cement filling vertebral. The clinical data of patients were prospectively analyzed and the clinical efficacy was compared between two groups. Results The VAS scores, Beck value, Cobb angle and ODI scores after operation improved in both groups (P < 0.01),but there were no significant difference between two groups(P > 0.05). The operative time, X-ray exposure time and volume of bone cement in unilateral group were less than that of bilateral group(P < 0.01). There were no significant difference in the incidence of bone cement leakage ,the pain relief and the incidence of complications between two groups (P > 0.05). Conclusion Both unipedicular and biopedicular PKP are significant improvement for the OVCF, vertebral strengthen showed similar efficacy, but the former has easy operation procedure, can shorten operative time and reduce X-ray exposure time and less volume of bone cement.