【摘要】 目的：探讨老年骨质疏松性椎体压缩性骨折（OVCF）实施不同入路经皮椎体成形术（PVP）的临床效果和安全性。方法：回顾性择取2022年3月—2025年3月钦州市第一人民医院收治的300例老年OVCF患者的资料，按照手术入路方式的不同分为对照组（150例，症状较轻侧入路）与观察组（150例，症状较重侧入路）。对比两组的手术相关指标、炎症应激指标、腰椎功能、腰椎稳定性、术后疼痛程度、并发症发生率。结果：两组手术用时、骨水泥用量比较，差异无统计学意义（P>0.05）。观察组骨折愈合时间早于对照组，住院时间短于对照组（P<0.05）。术后3、6个月，两组Oswestry功能障碍指数（ODI）、VAS评分均低于术前，且观察组低于对照组（P<0.05）。术后3、6个月，两组椎体前缘高度高于术前，后凸Cobb角小于术前（P<0.05），但两组间比较，差异无统计学意义（P>0.05）。术后3 d，两组CRP、TNF-α、皮质醇（Cor）、前列腺素E₂（PGE₂）水平均高于术前，但观察组各指标水平低于对照组（P<0.05）；术后7 d，两组CRP、TNF-α、Cor、PGE₂水平均低于术前、术后3 d，且观察组低于对照组（P<0.05）。两组术后并发症发生率比较，差异无统计学意义（P>0.05）。结论：老年OVCF患者分别从症状较轻侧、症状较重侧入路行PVP治疗，均能有效改善腰椎稳定性，但相较而言选择症状较重侧入路PVP具有减轻术后疼痛、降低炎症应激反应、促进骨折愈合、提高腰椎功能的应用优势。更多还原

【Abstract】 Objective: To investigate the clinical efficacy and safety of percutaneous vertebroplasty（PVP） with different approaches for elderly osteoporotic vertebral compression fractures（OVCF）. Method: The data of 300 elderly patients with OVCF admitted to the First People’s Hospital of Qinzhou from March 2022 to March 2025 were retrospectively selected and divided into the control group（150 cases, the approach on the side with milder symptoms） and the observation group（150 cases, the approach on the side with more severe symptoms） according to different surgical approaches. The surgical-related indicators, inflammation stress indicators, lumbar function, lumbar stability, postoperative pain degree and complication rate of the two groups were compared. Result: There were no statistically significant differences in the operation time and bone cement dosage between the two groups（P>0.05）. The fracture healing time of the observation group was earlier than that of the control group, and the hospital stay was shorter than that of the control group（P<0.05）. At 3 and 6 months after the operation, the Oswestry disability index（ODI） and VAS scores of both groups were lower than those before the operation, and those of the observation group were lower than those of the control group（P<0.05）. At 3 and 6 months after the operation, the anterior height of the vertebral bodies in both groups were higher than those before the operation, and the kyphotic Cobb angle were smaller than those before the operation（P<0.05）, but there were no statistically significant differences between the two groups（P>0.05）. Three days after the operation, the levels of CRP, TNF-α, cortisol（Cor）, and prostaglandin E₂（PGE₂） in both groups were higher than those before the operation, but the levels of each index in the observation group were lower than those in the control group（P<0.05）. Seven days after the operation, the levels of CRP, TNF-α, Cor and PGE₂ in both groups were lower than those before the operation and 3 days after the operation, and the levels in the observation group were lower than those in the control group（P<0.05）. There was no statistically significant difference in the incidence of postoperative complications between the two groups（P>0.05）. Conclusion: For elderly patients with OVCF, PVP treatment from the side with milder symptoms and the side with more severe symptoms approach can effectively improve lumbar stability. However, compared with the other approach, choosing the side with more severe symptoms approach for PVP has the application advantages of reducing postoperative pain, lowering inflammatory stress response, promoting fracture healing, and improving lumbar function.更多还原