摘要
[目的]探讨参照术前CT影像测量数据,经单侧椎弓根旁入路经皮椎体后凸成形术(PKP)治疗骨质疏松性胸腰椎椎体压缩骨折的可行性和临床疗效。[方法]将胸腰椎骨质疏松性椎体压缩骨折86例患者,共111节椎体,随机分为两组。实验组通过CT影像精确指导经单侧椎弓根旁入路行PKP术。对照组采用经典经单侧椎弓根入路手术。按照VAS评分、Oswetry评分标准及影像学资料分别对患者疼痛、日常活动功能及椎体高度、Cobb角进行比较,记录两组手术时间和术中透视时间。[结果]实验组43例,共55节椎体顺利完成手术,发生骨水泥软组织漏3例。对照组43例共56节椎体完成手术,发生脊髓损伤1例,经对症治疗相关症状缓解;两组发生骨水泥软组织漏6例。均无肺栓塞等并发症。VAS评分及ODI值,术前与术后1 d、12个月有显著性差异(P<0.05)。[结论]经CT影像测量数据指导行单侧经椎弓根旁入路椎体后凸成形术治疗骨质疏松性胸腰椎椎体压缩骨折可以取得满意疗效,而且具有手术时间短、穿刺准确性高、放射线辐射小等优点。
[ Objective] To explore the feasibility and clinical results of percutaneous vertebroplasty via unilateral extrape- dicular approach guided by preoperative CT image in treating the thoracolumbar junction vertebral compression fractures. [ Method] Eighty-six patients with osteoporotic vertebral compression fractures （111 vertabrae）were divided into two groups at random. Experiment group received procedure of percutaneous vertebroplasty via unilateral extrapedicular approach guided by preoperative CT image that direct the puncture angle and skin needle entry point, and control group was processed by classical operation via unilateral transpedicnlar apprOaCh. Pain and disability were measured using visual analogue scale （ VAS）, the Os- westry disability index （ODI） respectively in ihe follow-up. The height of the compromised vertabral body, the kyphotic angle were measured. The puncture-time and fluoroscopic time were noted. [ Result ] In experiment group,g3 cases （56 vertabrae）were accomplished, the operative success rate was 100%. Control group included only 40 patients （59 vertebrae）. Six patient were found cement leakage without clinical symptom in both groups, and 1 case with spinal cord injury in control Group. At the fallow- up, there were no significant differnce in the height of vertebral body, the kyphotic angle, VAS and ODI between two groups （ P 〉 0. 05 ）. However, there were significant difference in the time of the puncture and fluoroscopic （ P 〈 0. 05）. [ Conclusion ] Percu- taneous vertebroplasty via unilateral extrapedicular approach guided by preoperative CT image is effctive, accurate, safe in trea- ting the thoracolumbar junction vertebral compression fractures. Unilateral extrapedicular PKP assisting CT image has less time of operation and radiation exposure.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2012年第22期2035-2038,共4页
Orthopedic Journal of China
