摘要
目的探讨单侧椎弓根入路经皮椎体成形术(PVP)治疗骨质疏松性椎体爆裂骨折(OVBF)的疗效及安全性。方法选择2020年5月至2022年5月广州市中西医结合医院脊柱外科收治的100例OVBF患者作为研究对象,按随机数表法将患者分为观察组和对照组各50例。对照组患者行双侧椎弓根入路PVP治疗,观察组患者行单侧椎弓根入路PVP治疗,观察至术后3个月。比较两组患者的手术情况以及术前、术后3个月的椎体前缘高度、Cobb角、视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数,并统计两组患者的并发症发生情况。结果观察组患者的手术时间、透视次数、骨水泥灌注量分别为(31.98±4.28)min、(15.98±3.12)次、(4.28±0.72)mL,明显短(少)于对照组的(40.98±4.32)min、(19.34±3.09)次、(5.99±0.68)m L,差异均有统计学意义(P<0.05);术后3个月,两组患者的椎体前缘高度明显高于术前,而Cobb角明显低于术前,差异均有统计学意义(P<0.05),但观察组患者术后3个月的椎体前缘高度、Cobb角分别为(20.98±2.11)cm、(9.21±1.23)°,对照组分别为(20.79±2.31)cm、(9.42±1.32)°,差异均无统计学意义(P>0.05);术后3个月,两组患者的VAS、Oswestry功能障碍指数均较术前降低,差异均有统计学意义(P<0.05),但观察组患者术后3个月的VAS、Oswestry功能障碍指数分别为(2.78±0.32)分、(32.14±3.28)分,对照组分别为(2.76±0.34)分、(32.09±3.21)分,差异均无统计学意义(P>0.05);观察组患者术后并发症发生率为4.00%,明显低于对照组的18.00%,差异有统计学意义(P<0.05)。结论单侧椎弓根入路PVP治疗OVBF的效果与双侧椎弓根入路效果相当,可促进椎体高度及腰椎功能恢复,缓解疼痛,但单侧椎弓根入路能够缩短手术时间,减少术中透视次数及骨水泥注入量,并发症少,具有临床应用价值。
Objective To investigate the efficacy and safety of percutaneous vertebroplasty(PVP)via unilater-al pedicle approach in the treatment of osteoporotic vertebral burst fracture(OVBF).Methods A total of 100 OVBF pa-tients admitted to Department of Spinal Surgery,Guangzhou Integrated Traditional Chinese and Western Medicine Hos-pital from May 2020 to May 2022 were selected as the study subjects.They were randomly divided into an observation group and a control group,with 50 patients in each group.Patients in the control group underwent PVP treatment via bi-lateral pedicle approach,while patients in the observation group underwent PVP treatment via unilateral pedicle ap-proach.The patients were followed up for 3 months after surgery.The surgical conditions,anterior vertebral height,Cobb angle,Visual Analogue Scale(VAS)score,and Oswestry dysfunction index before and 3 months after surgery were compared between the two groups,and the incidence of complications in the two groups was statistically analyzed.Results The operation time,fluoroscopy times,and bone cement perfusion volume in the observation group were(31.98±4.28)min,(15.98±3.12)times,(4.28±0.72)mL,which were shorter(or less)than(40.98±4.32)min,(19.34±3.09)times,(5.99±0.68)mL in the control group(P<0.05).Three months after surgery,the anterior vertebral height in the two groups was significantly higher than that before surgery,while the Cobb angle was significantly lower than that before surgery,with statistically significant differences(P<0.05);the anterior vertebral height and Cobb angle were(20.98±2.11)cm and(9.21±1.23)°at three months after surgery in the observation group and(20.79±2.31)cm and(10.11±1.32)°in the control group,with no statistically significant differences(P>0.05).At 3 months after surgery,the VAS and Oswestry dysfunction index of the two groups decreased significantly compared to those before surgery(P<0.05),but they showed no statistically significant differences between the two groups at 3 months after surgery:(2.76±0.34)points and(32.09±3.21)points in the observation group versus(2.78±0.32)points and(32.09±3.21)points in the control group,P>0.05.The incidence of postoperative complications in the observation group was 4.00%,which was sig-nificantly lower than 18.00%in the control group(P<0.05).Conclusion The effect of PVP via unilateral pedicle ap-proach in the treatment of OVBF is equivalent to that of PVP via bilateral pedicle approach,which can promote the re-covery of vertebral height and lumbar function,alleviate pain.However,PVP via bilateral pedicle approach can shorten surgical time,reduce intraoperative fluoroscopy frequency and bone cement injection,and bring fewer complications.
作者
冯永辉
李富文
秦丰伟
陈文
张思能
谢春亮
梁杰
FENG Yong-hui;LI Fu-wen;QIN Feng-wei;CHEN Wen;ZHANG Si-neng;XIE Chun-liang;LIANG Jie(Department of Spinal Surgery,Guangzhou Integrated Traditional Chinese and Western Medicine Hospital,Guangzhou 510000,Guangdong,CHINA;Department of Orthopedics,Yunfu Yuncheng People's Hospital,Yunfu 527399,Guangdong,CHINA)
出处
《海南医学》
CAS
2023年第20期2941-2945,共5页
Hainan Medical Journal
基金
广东省广州市重大疑难疾病中西医协同治疗建设项目[编号:1010011920(2100601)]
广东省广州市卫生健康科技一般引导项目(编号:20221A010082)。
关键词
骨质疏松性椎体爆裂骨折
经皮椎体成形术
单侧椎弓根入路
腰椎功能
疼痛
并发症
Osteoporotic vertebral burst fracture
Percutaneous vertebroplasty
Unilateral pedicle approach
Lumbar function
Pain
Complication
