Binzhou Medical University Hospital
[目的]探讨经皮椎体后凸成形术（percutaneous kyphoplasty, PKP）治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture, OVCF)过程中不利于球囊扩张的相关因素及球囊扩张形态差异可能导致的并发症。[方法]回顾性分析我院2018年1月～2019年12月行PKP治疗的153例OVCF患者。按术中球囊扩张形态分成饱满组与未饱满组，其中饱满组103例；未饱满组50例。比较两组的一般资料；比较两组手术前后及随访各阶段的VAS评分；比较分析两组病程、压缩度、局部Cobb角及术前各组Kümmell’s病例数；记录两组手术及随访期间并发症的发生情况。[结果]所有患者均顺利完成手术，且术后VAS评分均较术前明显降低（P＜0.05）。饱满组术中发生7例骨水泥漏（6.80%），未饱满组发生6例（12.00%），差异无统计学意义（P＞0.05）。饱满组病程、压缩度、局部Cobb角及Kümmell’s病例数均低于未饱满组（P＜0.05），而且是造成球囊扩张未饱满的危险因素（P＜0.05）。末次随访饱满组发生1例伤椎再骨折（0.97%），未饱满组发生5例（10.00%），未饱满组发生伤椎再骨折的几率明显大于饱满组（P＜0.05）。[结论]病程、压缩度、局部Cobb角及Kümmell’s病是PKP治疗OVCF中不利于球囊扩张的相关因素，且球囊扩张未饱满可增加患者术后伤椎再骨折的几率。
[Objective] To investigate percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture (OVCF) and possible complications caused by balloon dilation morphological differences.[Methods] A retrospective analysis was performed on 153 patients with OVCF who received PKP treatment in our hospital from January 2018 to December 2019. According to the intraoperative balloon dilation morphology, it was divided into full group and not full group. There were 103 cases in full group. There were 50 cases in the unplumped group. General information was compared between the two groups. VAS scores were compared between the two groups before and after operation and at each stage of follow-up. The course of disease, compression degree, local Cobb Angle and the number of Kummell's cases before operation were compared and analyzed between the two groups. The incidence of complications during operation and follow-up were recorded.[Results] All patients successfully completed the surgery. Postoperative VAS scores were significantly lower than those before surgery (P<0.05). There were 7 cases of bone cement leakage (6.80%) in the full group and 6 cases (12.00%) in the unfull group, with no statistical significance (P>0.05). The course of disease, compression degree, local Cobb Angle and Kummell's cases in full group were lower than those in non-full group (P<0.05), and were risk factors for incomplete balloon dilation (P<0.05). At the last follow-up, there was 1 case (0.97%) of refracture of injured vertebra in the full group and 5 cases (10.00%) in the unfull group. The rate of refracture of injured vertebra in the unfull group was significantly higher than that in the full group (P<0.05). [Conclusion] The course of disease, compression degree, local Cobb Angle and Kummell's disease are the related factors that are not conducive to balloon dilation in PKP treatment of OVCF, and incomplete balloon dilation can increase the risk of postoperative vertebral re-fracture.