两种单侧经皮穿刺椎体后凸成形术治疗单节段胸腰段骨质疏松椎体压缩骨折的疗效比较OA

Objective To investigate the differences in clinical efficacy between percutaneous curved kyphoplasty(PCKP)and unilateral percutaneous kyphoplasty(UPKP)in the treatment of thoracolumbar osteoporotic vertebral compression fractures(OVCF),with a focus on evaluating cement distribution,leakage risk,and vertebral biomechanical restoration.Methods A to-tal of 78 patients with acute thoracolumbar OVCF admitted between January 2022 and April 2024 were included.They were divided into a PCKP group and a UPKP group based on the surgical technique.The PCKP group comprised 37 cases,including 12 males and 25 females,with an age of(78.84±11.24)years and a bone mineral density T value of-4.05±0.81.The UPKP group included 41 cases,comprising 17 males and 24 females,with an age of(77.68±10.73)years and a bone mineral density T value of-4.15±0.82.Comparisons were made between the two groups regarding preoperative and postoperative visual ana-logue scale(VAS)pain scores,Oswestry disability index(ODI)scores,anterior vertebral body height,rate of good/excellent cement distribution,cement leakage rate,and surgery-related parameters.Results All patients were followed up for 12 months.In the PCKP group,the mean VAS preoperatively,and at 2 days,3 months,and 12 months postoperatively were(6.35±2.34),(2.95±0.70),(1.76±1.19),and(0.97±0.80)points,respectively.Corresponding scores in the UPKP group were(6.83±2.23),(3.15±0.82),(1.73±1.12),and(1.17±0.74)points.The mean ODI scores in the PCKP group at the same time points were(75.73±3.42),(34.57±3.18),(24.03±5.24),and(22.84±1.68)points,respectively,compared to(74.41±2.85),(35.54±3.49),(24.95±2.85),and(22.66±1.70)points in the UPKP group.Both groups showed significant improvement in VAS and O-DI scores postoperatively(P＜0.05),but no statistically significant differences were observed between the groups(P＞0.05).The rate of good/excellent cement distribution in the PCKP group was 91.89％(34/37),significantly higher than the 65.85％(27/41)in the UPKP group(P=0.001).The cement leakage rate was 13.51％(5/37)in the PCKP group,which was significantly lower than the 34.15％(14/41)in the UPKP group(P=0.030).No significant difference was found in the degree of vertebral compression between patients with poor cement distribution/leakage and those without in either group(P＞0.05).The mean ante-rior vertebral body height in the PCKP group increased from(13.22±2.47)mm preoperatively to(16.68±1.42)mm at 2 days postoperatively.In the UPKP group,it increased from(13.80±2.50)mm to(17.02±1.35)mm at 2 days postoperatively.Both groups showed significant restoration of anterior vertebral height postoperatively(P＜0.05),with no significant intergroup differ-ence(P＞0.05).Re-fractures occurred in 4 cases in the PCKP group and 6 cases in the UPKP group,showing no significant in-tergroup difference(P＞0.05).No significant differences were found in operative time or fluoroscopy frequency between the two groups(P＞0.05).Conclusion PCKP,utilizing a curved drill technique,optimizes bilateral cement dispersion,significantly im-proving distribution uniformity and reducing leakage risk,making it particularly suitable for moderate-to-severe compression fractures.Its technical characteristics such as unilateral puncture and low-pressure cement infusion-provide a safer and more effective minimally invasive solution for thoracolumbar OVCF without increasing operative time or radiation exposure.Future studies with larger sample sizes and longer follow-up are needed to verify its long-term biomechanical advantages.