摘要
[目的]比较弯角单侧穿刺椎体成形术(percutaneous vertebroplasty, PVP)与传统双侧穿刺椎体成形术治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture, OVCF)的临床疗效,探讨弯角单侧椎体成形术的临床应用价值。[方法]回顾性分析本院收治的39例OVCF患者临床资料,其中17例采用弯角单侧穿刺PVP,22例采用传统双侧穿刺PVP,比较两组患者术前和术后临床疗效及影像学参数。[结果]两组患者均顺利完成手术,无严重并发症,两组患者均未发生骨水泥渗漏。弯角单侧组手术时间、术中透视次数及骨水泥注入量均显著小于传统双侧组(P<0.05),两组患者首次下地活动时间的差异无统计学意义(P>0.05),且随时间推移,两组患者VAS和ODI均显著降低(P<0.05),两组间VAS和ODI评分的差异均无统计学意义(P>0.05)。影像学方面,与术前相比,两组术后各时间点椎体相对高度均显著增加(P<0.05),局部后凸Cobb角显著减小(P<0.001)。相应时间点,两组间椎体前缘相对高度和局部后凸Cobb角度的差异均无统计学意义(P>0.05)。[结论]弯角单侧PVP与传统双侧PVP治疗OVCF均可获得满意疗效,但前者具有手术时间短、放射暴露次数少、骨水泥注入量少等优势。
[Objective] To compare the clinical outcomes of percutaneous vertebroplasty(PVP) by curved unilateral puncture versus conventional straight bilateral puncture for thoracolumbar osteoporotic vertebral compression fracture(OVCF) in the elderly. [Methods] A retrospective study was conducted on 39 patients who received PVP for OVCF. Among them, 17 patients had PVP performed by curved unilateral puncture technique, while the remaining 22 patients were by traditional straight bilateral puncture technique. The clinical and imaging data were compared between the two groups. [Results] All patients in both groups were successfully operated on without serious complications during the operation, while the intraoperative images revealed that no bone cement leakage was noted in anyone of the two groups.The unilateral group consumed significantly shorter operation time, associated with significantly less numbers of intraoperative fluoroscopy and the amount of bone cement injected than the bilateral group(P<0.05), but there were no significant differences in time to return to walking and full weight bearing activity between the two groups(P>0.05). Both the VAS and ODI scores in the two groups decreased significantly over time(P<0.05), however, there was no statistically significant difference in VAS and ODI scores between the two groups at any corresponding time point(P>0.05). In terms of radiographic evaluation, the relative height of the vertebral body significantly increased(P<0.05), while the local kyphotic Cobb.s angle significantly decreased at all time points postoperatively compared with those before operation(P<0.05). At any corresponding time point, no significant differences were found in the relative vertebral height and the local kyphotic Cobb angle between the two groups(P>0.05). [Conclusion] Both curved unilateral and straight bilateral PVPs do achieve satisfactory clinical outcomes for thoracolumbar osteoporotic vertebral compression fractures, by comparison, the former has the advantages of shorter operation time, less radiation exposure and bone cement injection.
作者
张亚
辛兵
ZHANG Ya;XIN Bing(Postgraduate School,Xuzhou Medical University,Xuzhou 221000,China;Department of Spine Surgery,The Affiliated Hospital,Xuzhou Medical University,Xuzhou 221000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第16期1519-1522,共4页
Orthopedic Journal of China
关键词
骨质疏松性椎体压缩骨折
经皮椎体成形术
弯角单侧入路
双侧入路
thoracolumbar osteoporotic vertebral compression fractures
percutaneous vertebroplasty
curved unilateral approach
straight bilateral approach
