| 杨蕙铭,李浩,张洋,等.靶向椎体成形术治疗症状性骨质疏松性椎体压缩骨折：一项随访超过2年的回顾性队列研究.骨科,2026,17(3): 213-218. |
| 靶向椎体成形术治疗症状性骨质疏松性椎体压缩骨折：一项随访超过2年的回顾性队列研究 |
| Targeted vertebroplasty for symptomatic osteoporotic vertebral compression fractures: A retrospective cohort study with over 2 years of follow-up |
| 投稿时间：2025-11-10 |
| DOI：10.3969/j.issn.1674-8573.2026.03.003 |
| 中文关键词: 骨质疏松性椎体压缩骨折 经皮椎体成形术 单侧入路 靶向 骨水泥分布 邻近椎体骨折 |
| 英文关键词: Osteoporotic vertebral compression fractures Percutaneous vertebroplasty Unilateral approach Targeted Bone cement distribution Adjacent vertebral fracture |
| 基金项目:西安市卫生健康委员会科研项目（2024ms11、2025yb14）；陕西省卫生健康科研创新能力提升计划重点研发项目（2025YF-15） |
| 作者 | 单位 | E-mail | | 杨蕙铭 | 陕西中医药大学,陕西咸阳 712000；西安交通大学附属红会医院脊柱病医院,西安 710054 | | | 李浩 | 西安交通大学附属红会医院脊柱病医院,西安 710054；延安大学,陕西延安 716000 | | | 张洋 | 西安交通大学附属红会医院脊柱病医院,西安 710054；延安大学,陕西延安 716000 | | | 樊磊磊 | 西安交通大学附属红会医院脊柱病医院,西安 710054；延安大学,陕西延安 716000 | | | 王宇航 | 西安交通大学附属红会医院脊柱病医院,西安 710054 | | | 王彪 | 陕西中医药大学,陕西咸阳 712000；西安交通大学附属红会医院脊柱病医院,西安 710054 | wangbiaowb1987@126.com |
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| 中文摘要: |
| 目的 比较单侧穿刺靶向经皮椎体成形术（percutaneous vertebroplasty，PVP）和常规PVP治疗症状性骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fractures，OVCFs）的临床疗效、影像学结果和并发症发生率。方法 回顾性分析2018年1月至2023年12月接受单侧穿刺PVP治疗的148例症状性OVCFs患者的临床资料。根据手术策略，分为靶向组（72例，行单侧穿刺靶向PVP）与常规组（76例，行单侧穿刺常规PVP）。临床评估指标包括疼痛视觉模拟量表（visual analogue scale，VAS）评分和Oswestry功能障碍指数（Oswestry disability index，ODI）等患者自我报告的结果；影像学评估指标包括伤椎矢状面Cobb角（CA）和骨水泥分布等放射学结果；同时比较两组骨水泥渗漏及邻近椎体骨折等并发症发生情况。结果 所有患者均获得至少2年的随访。术后第1天，靶向组的VAS评分与ODI显著优于常规组，差异有统计学意义（P＜0.05）；但在术后6个月及2年随访时，两组间上述临床指标差异无统计学意义（P＞0.05）。各随访节点两组间的CA改善情况无显著差异（P＞0.05），但影像学证实靶向组的骨水泥分布显著优于常规组（P＜0.05）。并发症方面，靶向组与常规组的骨水泥渗漏发生率无显著差异（P＞0.05）；随访期间靶向组未发生邻近椎体骨折，其发生率显著低于常规组（6例），差异有统计学意义（P＜0.05）。结论 与单侧常规PVP相比，单侧靶向PVP治疗症状性OVCFs的早期疼痛缓解与功能改善更优，骨水泥在伤椎内的弥散分布更好，有效降低了远期邻近椎体骨折的风险。 |
| 英文摘要: |
| Objective To compare the clinical efficacy, radiological outcomes and complications of unilateral targeted percutaneous vertebroplasty (t-PVP) versus unilateral conventional percutaneous vertebroplasty (c-PVP) in the treatments of symptomatic osteoporotic vertebral compression fractures (OVCFs). Methods A retrospective analysis was conducted on 148 patients with symptomatic OVCFs who underwent unilateral PVP from January 2018 to December 2023. Patients were divided into the targeted group (72 cases, underwent t-PVP) and the conventional group (76 cases, underwent c-PVP). Clinical evaluations included the patient self-reported results such as the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). Radiological assessments involved the sagittal Cobb angle (CA) of the fractured vertebra and cement distribution. Complications, including bone cement leakage and adjacent vertebral fractures, were also recorded and compared. Results All patients were followed up for at least 2 years. At 1 day postoperatively, the targeted group demonstrated significantly better VAS scores and ODI compared to the conventional group (P＜0.05); however, no significant differences were observed between the two groups at 6 months and 2 years postoperatively (P＞0.05). There was no statistically significant difference in CA between the two groups at any follow-up time point (P＞0.05). Radiologically, bone cement distribution was significantly superior in the targeted group (P＜0.05). The incidence of cement leakage did not differ significantly between the targeted and conventional groups (P＞0.05). Notably, no adjacent vertebra fractures occurred in the targeted group, reflecting a significantly lower incidence than in the conventional group (P＜0.05). Conclusion Compared with unilateral c-PVP, unilateral t-PVP provides superior early pain relief and functional recovery for patients with symptomatic OVCFs. Furthermore, t-PVP optimizes bone cement dispersion within the fractured vertebra and effectively reduces the long-term risk of adjacent vertebral fractures. |
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