KYPHOPLASTY AND VERTEBROPLASTY IN THE TREATMENT OF OSTEOPOROTIC VERTEBRAL FRACTURES

ABSTRACT Objective: To compare these procedures in the treatment of osteoporotic vertebral compression fractures. Methods: Patients who underwent vertebral augmentation procedures between March 2010 and October 2016 were selected for the study. Kyphosis, anterior vertebral height, Oswestry Disability Index (ODI), Visual Analog Scale (VAS), number of portals, cement volume, and complications were recorded. The results were analyzed by difference of the means. Results: Sixty-eight patients were selected, accounting for 105 procedures. A statistically significant improvement was observed in VAS and ODI with both procedures (p<0.001) without statistically significant difference between them, regardless of the number of portals or cement applied. There was a high correlation between kyphosis correction and ODI improvement (p =0.012). Conclusions: Both vertebroplasty and kyphoplasty are effective procedures for the treatment of vertebral compression fractures. We found no significant difference between both procedures. The high correlation between improvement of kyphosis and ODI suggests that these procedures are better than conservative treatment to improve the quality of life of patients, however more studies are required to reach a final conclusion. Level of Evidence III; Retrospective comparative study.

摘要
研究目的：比较不同术式治疗骨质疏松性椎体压缩骨折的临床效果。
研究方法：选取2010年3月至2016年10月间接受椎体强化术式治疗的患者纳入本研究。记录患者的后凸畸形角度、椎体前缘高度、Oswestry功能障碍指数（Oswestry Disability Index, ODI）、视觉模拟评分法（Visual Analog Scale, VAS）、穿刺通道数量、骨水泥注入量及并发症发生情况，采用均数差异分析法对所得结果进行统计处理。
研究结果：共纳入68例患者，累计完成105例手术。两种术式均可显著改善VAS评分与ODI评分（p<0.001），且二者疗效无统计学差异，不受穿刺通道数量或骨水泥注入量的影响。后凸畸形矫正程度与ODI评分改善呈高度相关（p=0.012）。
研究结论：椎体成形术与后凸成形术均为治疗椎体压缩骨折的有效术式，二者临床疗效无显著差异。后凸畸形改善与ODI评分提升的高度相关性提示，上述术式在改善患者生活质量方面优于保守治疗，但仍需开展更多相关研究以得出最终结论。
证据等级：Ⅲ级；回顾性对照研究。