Jack椎体扩张器与球囊扩张后凸成形术后伤椎高度丢失与邻近椎间盘退变的比较研究

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目的:比较Jack椎体扩张器后凸成形术(DKP)与Kyphon球囊扩张后凸成形术(BKP)治疗骨质疏松椎体压缩性骨折(OVCF)术后伤椎高度丢失与邻近椎间盘退变的情况。方法:回顾性研究2007年5月至2016年10月南京医科大学第一附属医院骨科收治的94例OVCF患者资料。根据治疗方法不同分为两组:DKP组(采用DKP治疗)30例,男18例,女12例;年龄(72.4±9.2)岁,骨密度值(-3.99±0.88)SD,病程(0.7±0.4)个月。BKP组(采用DKP治疗)64例,男28例,女36例;年龄(71.6±14.3)岁,骨密度值(-4.08±0.63)SD,病程(0.6±0.3)个月。比较两组患者术前、术后2 d及术后36个月伤椎高度变化、邻近椎间盘高度指数百分比(DHIP)和椎间盘退变的Pfirrmann分级。结果:两组患者术前一般资料比较差异均无统计学意义(n P>0.05),具有可比性。两组患者术后36个月伤椎前缘、中间高度及DHIP均低于术后2 d,差异有统计学意义(n P0.05). The anterior and middle heights of injured vertebrae and DHIP at postoperative 36 months were significantly lower than those at postoperative 2 days in both groups (n P<0.05). There was no significant difference between the 2 groups in DHIP at 36 months after operation (79.86%±4.48% versus 80.24%±6.85%) (n t=0.277, n P=0.782). By the Pfirrmann grading, 36 and 84 patients had intervertebral disc degeneration in DKP and BKP groups respectively. There was no significant difference in the incidence of intervertebral disc degeneration between the 2 groups (60.0% versus 65.6%) (χn 2=0.560, n P=0.454).n Conclusions:In the OVCF treatment, DKP and BKP may potentially cause height loss of the injured vertebrae and degeneration of adjacent intervertebral disc, but no difference was found in disc degeneration between the 2 modes.
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