摘要
[目的]探讨单个球囊双侧序贯扩张椎体后凸成形术预防复位椎体术中再塌陷的有效性。[方法]纳入2016年1月~2016年12月收治的80例骨质疏松性椎体骨折患者,随机分成两组,每组40例。双侧组采用单球囊双侧序贯扩张椎体后凸成形术,单侧组采用单个球囊单侧扩张椎体后凸成形术。记录两组围手术期资料,采用疼痛视觉模拟评分(VAS),Oswestry功能障碍指数(ODI)和影像测量评估临床效果。[结果]双侧组的手术时间、X线暴露时间、骨水泥注入量均显著大于单侧组,但差异有统计学意义(P<0.05)。双侧组的骨水泥渗漏率低于单侧组,但差异无统计学意义(P>0.05)。双侧组的骨水泥弥散面积率明显高于单侧组,差异有统计学意义(P<0.05)。两组患者术中球囊扩张后椎体前缘高度的差异无统计学意义(P>0.05);但球囊取出后的椎体前缘高度双侧组高于单侧组,差异有统计学意义(P<0.05)。双侧组术后1 d的椎体前缘高度大于单侧组,而椎体后凸角小于单侧组,差异均有统计学意义(P<0.05)。两组患者术后1 d的VAS、ODI差异无统计学意义(P>0.05)。术后12个月,双侧组椎体前缘高度仍显著大于单侧组,差异有统计意义(P<0.05);此时两组椎体前缘高度均较术后1 d时减少,差异有统计学意义(P<0.05)。[结论]单个球囊双侧序贯扩张椎体后凸成形术能较好的恢复椎体高度,有效预防复位椎体术中再塌陷。
[Objective] To investigate the effectiveness of bilateral sequential dilatation with a single balloon in vertebral kyphoplasty to prevent vertebral re-collapse. [Methods] From January 2016 to December 2016, 80 patients with osteoporotic vertebral compression fracture（OVCF） were randomly divided into two groups, with 40 cases in each group. The patients in the bilateral group underwent bilateral sequential dilation in kyphoplasty with a single balloon, while those in the unilateral group had only unilateral dilation in kyphoplasty. The perioperative data were collected, additionally, the visual analog score（VAS）, Oswestry disability index（ODI） and radiographic measures were used for evaluation of clinical consequences.[Results] The bilateral group took statistically longer operation time, more frequencies of radiation exposure, greater amount of bone cement injected than the unilateral group（P〈0.05）. However, the bilateral group had a lower rate of cement leakage despite no a statistical difference compared with the unilateral group（P〉0.05）. In addition, the bilateral group proved statistically greater cement diffusion area than the unilateral group（P〈0.05）. Although no significant difference regarding to the anterior vertebral height during balloon dilation was found between the two groups（P〉0.05）, the bilateral group got statistically greater anterior vertebral height after the balloon withdrawal than the unilateral group（P〈0.05）. At 1 day after operation, the bilateral group had statistically greater anterior vertebral height, whereas less Cobb angle than the unilateral group（P〈0.05）. In term of clinical presentation, there were on statistical differences regarding to VAS and ODI between the two groups at 1 day postoperatively（P〉0.05）. At 12 months after operation, the bilateral group remained statistically greater anterior vertebral height than the unilateral group（P〈0.05）, despite the fact that the heights significantly decreased in both group compared to those 1 day after operation（P〈0.05）. [Conclusion] Bilateral sequential dilation with a single balloon during kyphoplasty does improve restoration of vertebral body height, and prevent re-collapse effectively during kyphoplasty.
作者
万趸
熊小明
孙育良
邓轩赓
石华刚
宋偲茂
WAN Dun;X;SUN Yu-liang;DENG Xuan-geng;SHI Hua-gang;SONG Si-mao(Department of Spine Sur-gery,Orthopedics Hospital of Sichuan Province,Chengdu 610041,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2018年第18期1658-1663,共6页
Orthopedic Journal of China
基金
四川省科技厅支撑项目(编号:2015SZ0190)
关键词
骨质疏松性椎体压缩性骨折
椎体后凸成形术
再塌陷
osteoporotic vertebral compression fracture （OVCF）；vertebral kyphoplasty；re-collapse
