Comparison of therapeutic effects between unilateral and bilateral percutaneous vertebroplasty for Kummell's disease

doi:10.3877/cma.j.issn.2095-8757.2023.02.002

Abstract

Abstract:

Objective

To compare the clinical efficacy of unilateral and bilateral percutaneous vertebroplasty (PVP) in the treatment of Kummell disease.

Methods

A total of 47 patients with single-level thoracolumbar Kummell's disease (stageⅡ) without neurological symptoms in the Second Hospital of Shanxi Medical University during January 2016 and July 2019 were selected. Among them, 24 cases were treated with unilateral pedicle surgery (unilateral PVP group), and 23 cases were treated with bilateral pedicle surgery (bilateral PVP group). Oswestry disability index (ODI), Roland-Morris disability questionnaire (RDQ) and visual analogue scale (VAS) were used for clinical evaluation before operation, 3 months and 12 months after operation. The vertebral height and kyphosis angle were measured on preoperative and postoperative X-ray films. The total operation time and the incidence of bone cement leakage in each group were recorded. T test and repeated measurement analysis of variance were used for comparison of measurement data, and χ² test was used for comparison of counting data.

Results

There were no intergroup difference in the comparison of ODI, RDQ, and VAS scores before and after surgery (F=0.743, 2.117, 0.429; P > 0.05). Compared with bilateral PVP group, the operation time of unilateral PVP group was significantly shortened (t=0.010, P < 0.01). There were no significant differences in the correction of spinal deformity and complications between the two groups.

Conclusion

Unilateral PVP and bilateral PVP have similar efficacy in the treatment of Kummell's disease, but unilateral PVP can shorten the operation time, so can be used as the first choice of surgical method for Kummell's disease.

Key words: Kummell's disease, Osteoporosis, Percutaneous vertebroplasty, Unilateral approach, Bilateral approach, Efficacy

Xiaohui Bai, Long Zhang, Yongfeng Wang, Yi Feng, Bin Zhao, Zhi Lyu, Chaojian Xu. Comparison of therapeutic effects between unilateral and bilateral percutaneous vertebroplasty for Kummell's disease[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2023, 10(02): 14-18.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlnbyjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-8757.2023.02.002

https://zhlnbyjdzzz.cma-cmc.com.cn/EN/Y2023/V10/I02/14

Figures/Tables 6

References 20

[1]	Tu Kn, Lie JD, Wan CKV, et al. Osteoporosis: A review of treatment options[J]. Pharm Ther, 2018, 43(2):92-104.
[2]	Hartley GW, Roach KE, Nithman RW, et al. Physical therapist management of patients with suspected or confirmed osteoporosis: A clinical practice guideline from the academy of geriatric physical therapy[J]. Geriatr Phys Ther, 2022, 44(2):E106-E119.
[3]	Huang CWC, Tseng IJ, Yang SW, et al. Lumbar muscle volume in postmenopausal women with osteoporotic compression fractures: Quantitative measurement using MRI[J]. Eur Radiol, 2019, 29(9):4999-5006.
[4]	Li J, Yuan X, Li F, et al. A randomized trial comparing the clinical efficacy and safety of a novel steerable percutaneous kyphoplasty with traditional PKP in osteoporotic vertebral fractures[J]. Ann Transl Med, 2021, 9(12):1024.
[5]	Moser M, Jost J, Nevzati E. Kyphoplasty versus percutaneous posterior instrumentation for osteoporotic vertebral fractures with posterior wall injury: A propensity score matched cohort study[J].Spine Surg, 2021, 7(1):68-82.
[6]	Pateder DB, Khanna AJ, Lieberman IH. Vertebroplasty and kyphoplasty for themanagement of osteoporotic vertebral compression fractures[J]. Orthop Clin North Am, 2007, 38:409-418.
[7]	张译徽，刘云涛，刘波，等.急性骨质疏松性椎体压缩性骨折患者早期骨髓水肿磁共振形态特征与经皮椎体成形术后骨水泥分布的关系[J].中华实用诊断与治疗杂志，2022，36(2):196-199.
[8]	钱建国，李娅，赵朝辉.椎体后凸成形术与保守治疗在骨质疏松椎体压缩性骨折治疗中的临床疗效[J].当代医学，2022，28(12):77-79.
[9]	Zhang F, Zhao QM, Ni XH, et al.Comparison of unilateral and bilateral puncture percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures[J]. Neurosciences (Riyadh), 2021, 26(3):236-241.
[10]	Chee CG, Yoon MA, Kim KW, et al. Combined radiomics-clinical model to predict malignancy of vertebral compression fractures on CT[J]. Eur Radiol, 2021, 31(9):6825-6834.
[11]	Li G, Walco JP, Mueller DA, et al. Reliability of the ASA physical status classification system in predicting surgical morbidity: A retrospective analysis[J]. Med Syst, 2021, 45(9):83.
[12]	刘富强，郝佩佩，徐海乔，等.单侧与双侧经皮椎体成形术治疗骨质疏松性椎体压缩骨折的疗效比较[J].广东医科大学学报，2019，37(5):557-560.
[13]	李庆达，杨俊松，高林，等.经皮椎体成形术与非手术治疗急性症状性骨质疏松性胸腰椎骨折分型Ⅰ型骨折的疗效比较[J].中华创伤杂志，2021，37(6):541-548.
[14]	阮丽萍，谢垒.骨质疏松性椎体压缩性骨折术后患者生存质量影响因素分析[J].中国现代医生，2021，59(35):81-84.
[15]	Bousson V, Hammze B, Odri G, et al. Percutaneous vertebral augmentation techniques in osteoporotic and traumatic fractures[J]. Semin Intervent Radiol, 2018, 35(4):309-323.
[16]	席聪.双侧经皮穿刺椎体成形术在治疗老年骨质疏松性胸腰椎压缩性骨折患者中的疗效分析[J].特别健康，2021，17(34):159.
[17]	廖亮，杨德顺，张庆，等.单侧经椎弓根外入路与双侧经椎弓根入路椎体成形术治疗骨质疏松性椎体压缩性骨折的比较[J].东南大学学报（医学版），2022，41(2)236-240.
[18]	柯铭锋，潘凡武，林久灶.单侧PVP技术在骨质疏松性中上胸椎骨折中的临床分析[J].中国综合临床，2015，37(12):31-34.
[19]	陈然，蒋传海，顾庆陟，等.单、双侧经皮穿刺椎体后凸成形术治疗胸腰段骨质疏松性椎体压缩骨折的疗效比较[J].颈腰痛杂志，2021，42(2):215-218.
[20]	梁雄飞，陈书连，赵小兵，等.单侧后外侧入路椎体成形术治疗腰椎骨质疏松性压缩骨折临床分析[J].中华实用诊断与治疗杂志，2016，30(5):492-494.

组别	例数	年龄（岁）	女性	ASA等级		骨折部位			骨折数量
组别	例数	年龄（岁）	女性	1或2	3或4	T5~T9	胸腰椎	腰椎	1处	2处
单侧PVP组	24	72.5±2.7	17（70.8）	16（66.7）	8（33.3）	5（20.8）	12（50.0）	7（29.2）	19（79.2）	5（20.8）
双侧PVP组	23	72.7±3.8	17（73.9）	16（69.6）	7（30.4）	5（21.7）	16（69.6）	2（8.7）	16（69.5）	7（30.5）
检验值		t=0.28	χ²=0.77	χ²=0.88	χ²=0.89	χ²=1.00	χ²=0.41	χ²=0.12	χ²=0.81	χ²=0.49
P值		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	年龄（岁）	女性	ASA等级		骨折部位			骨折数量
组别	例数	年龄（岁）	女性	1或2	3或4	T5~T9	胸腰椎	腰椎	1处	2处
单侧PVP组	24	72.5±2.7	17（70.8）	16（66.7）	8（33.3）	5（20.8）	12（50.0）	7（29.2）	19（79.2）	5（20.8）
双侧PVP组	23	72.7±3.8	17（73.9）	16（69.6）	7（30.4）	5（21.7）	16（69.6）	2（8.7）	16（69.5）	7（30.5）
检验值		t=0.28	χ²=0.77	χ²=0.88	χ²=0.89	χ²=1.00	χ²=0.41	χ²=0.12	χ²=0.81	χ²=0.49
P值		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	术前	术后3个月	术后12个月
单侧PVP组	24	28.21±3.20	15.29±3.42	11.92±2.08
双侧PVP组	23	28.13±3.52	14.78±2.75	11.26±2.32

组别	例数	术前	术后3个月	术后12个月
单侧PVP组	24	28.21±3.20	15.29±3.42	11.92±2.08
双侧PVP组	23	28.13±3.52	14.78±2.75	11.26±2.32

组别	例数	术前	术后3个月	术后12个月
单侧PVP组	24	16.04±1.65	7.33±4.24	7.29±2.54
双侧PVP组	23	16.35±1.50	10.17±4.81	6.48±2.66

Please choose a citation manager

Content to export