摘要
目的探讨经皮穿刺椎体后凸成形术(Percutaneous kyphoplasty,PKP)治疗椎体压缩性骨折术中单侧与双侧椎弓根穿刺方法在手术时间、并发症、术后疗效的区别。方法回顾西安交通大学医学院第一附属医院骨科68例(96个椎体)采用PKP方法治疗骨质疏松性椎体压缩性骨折患者资料,其中62个椎体采用单侧椎弓根穿刺,34个椎体采用双侧椎弓根穿刺。统计术中采取两种方法的手术时间、骨水泥注入量、术中透视机使用次数,用视觉模拟评分(Vas法)评估疼痛程度,Lee法测量椎体前缘高度压缩率,Cobb法测量椎体后凸角度,记录术前术后的改变情况,分析手术的有效性和安全性。结果所有患者均顺利完成手术,单侧穿刺法与双侧穿刺法显示了同样的临床及影像学结果。单侧穿刺法的单椎体手术时间、骨水泥注射量、透视机使用频率均低于双侧穿刺法,两种方法比较有显著性差异。VAS评分、椎体前缘高度压缩率改善情况、椎体后凸角度改善情况、围手术期并发症两种方法之间无显著性差异。结论单侧穿刺法创伤小,操作时间短,暴露射线时间短,临床疗效与双侧穿刺无显著性差异。
Objective To explore the differences of operation time, complications, and post-surgery efficacies between unipedicular approach and bipedicular approach in percutaneous kyphoplasty （PKP） for the treatment of osteoporotic vertebral compression fractures （OVCFs）. Methods The information of 68 OVCFs patients （96 vertebrae）treated with PKP in the First Affiliated Hospital of Xihn Jiaotong University were reviewed, including 62 vertebrae treated with unipedicular PKP and 34 vertebrae with bipedicular PKP. The operation time, amount of bone cement injection, and times of fluoroscopy used in the two approaches were recorded and analyzed statistically. The pain was assessed using visual analogue scale （VAS） scores. The compression rate of anterior vertebral height was measured using Lee method, and the posterior vertebral angle was measured using Cobb method. The variations before and after the operation were recorded. The efficacy and safety of the surgery were analyzed. Results All patients were successfully operated. The clinical and image outcomes of unipedicular PKP and bipedicular PKP were the same. The operation time, amount of bone cement injection, and times of fluoroscopy used in unipedieular PKP were lower than those in bipedicular PKP, and the differences were statistically significant. There were no significant differences of VAS scores, the improvement of anterior vertebral height, the posterior vertebral angle, and peri-operative complications between unipedicular PKP and bipedicular PKP. Conclusion The trauma of surgery, operation time, and time of radiological explosion of unipedicular PKP are lower or shorter than those of bipedicular PKP. The clinical efficacy has no significant difference comparing to bipedicular PKP.
出处
《中国骨质疏松杂志》
CAS
CSCD
2011年第11期957-960,共4页
Chinese Journal of Osteoporosis
