Abstract: Objective To investigate the clinical effect of unilateral percutaneous kyphoplasty （PKP） in the treatment of vertebral compression fracture in the elderly from the perspective of the injected volume and distribution of bone cement. Methods The clinical data of 60 elderly patients with vertebral compression fracture who were treated in the hospital from September 2019 to September 2022 were retrospectively analyzed. According to the position of bone cement in vertebral body displayed on postoperative thoracolumbar orthotopic X-ray film, the patients were divided into control group （eccentric distribution, 31 cases） and observation group （centric distribution, 29 cases）. Perioperative parameters of the two groups were compared. Changes in pain scores and imaging data before operation, 1 week, 6 months and 12 months after operation, activities of daily living and the incidence rates of complications in the two groups were recorded. Results There was no statistically significant difference between the two groups in terms of surgical time, blood loss, length of hospital stay, injected volume of bone cement and the incidence of complications （P>0.05）. The Visual Analog Scale （VAS） scores, Oswestry disability index （ODI） scores and kyphosis angles （Cobb angle） of the two groups decreased at 1 week, 6 months and 12 months after operation. The VAS score, ODI score and Cobb angle of the observation group were lower than those of the control group at each time point （P<0.05）. Conclusion The distribution of bone cement in elderly patients with vertebral compression fracture after unilateral PKP can affect the curative effect. Eccentric distribution can delay pain relief and affect quality of life of the patients. Therefore, centric distribution of bone cement should be maintained as much as possible.

Key words: vertebral compression fracture, bone cement, unilateral approach, percutaneous kyphoplasty

摘要： 目的 探讨单侧经皮椎体后凸成形术（PKP）治疗老年椎体压缩骨折中骨水泥灌注量及椎体内分布的临床疗效。方法 回顾性分析2019年9月至2022年9月在我院进行治疗60例椎体压缩骨折的老年患者临床资料,依据术后患者胸腰椎正位X片中椎体内骨水泥的位置分为对照组（呈偏心性分布）31例,观察组（呈中心性分布）29例。比较两组围术期参数,记录两组术前、术后1周、术后6个月及术后12个月的疼痛评分、影像学数据变化、日常生活自理能力及并发症发生状况。结果 两组手术时间、失血量、住院时间、骨水泥注射量及并发症发生率比较差异不具有统计学意义（P>0.05）。术后1周、术后6个月及术后12个月两组视觉疼痛模拟量表评分（VAS）、Oswestry功能障碍指数（ODI）、椎体后凸角度（Cobb角）均下降,且观察组各时间点VAS、ODI、Cobb角均低于对照组,差异具有统计学意义（P<0.05）。结论 对老年椎体压缩骨折患者经单侧PKP治疗后骨水泥分布形态可影响患者疗效,偏中心分布可延缓患者疼痛减轻进程,影响患者生活质量,在手术过程中应尽量保持骨水泥中位分布。

关键词: 椎体压缩骨折, 骨水泥, 单侧入路, 经皮椎体后凸成形术