单侧经椎弓根基底外侧穿刺治疗胸腰段椎体压缩性骨折  

Treatment Of Osteoporotic Spinal Compression Fractures by Unipedicular Vertebroplasty

作　　者：余彬[1] 陈勤[1] 邓宁[1] 

机构地区：[1]成都市第三人民医院骨科,四川成都610031

出　　处：《华西医学》2009年第7期1673-1675,共3页West China Medical Journal

摘　　要：目的:探讨单侧经椎弓根基底部外侧穿刺进针的可行性和安全性。方法:14例椎体压缩性骨折经椎弓根基底外侧穿刺进针,球囊扩张,骨水泥注入治疗,使用VAS评分法评价患者疼痛变化,测定手术前后椎体前、中柱高度与Cobb角。结果:单侧经椎弓根基底外侧穿刺的手术均安全完成。VAS评分由术前平均(8.5±0.3)分改善到术后(2.2±0.2)分,随访三月为(2.1±0.4)分(与术前比较,P<0.05);椎体前缘高度由术前(13.6±2.3)mm到术后(24.5±2.2)mm,随访三月为(24.3±2.0)mm(与术前比较,P<0.05);锥体中部高度由术前(14.2±2.1)mm到术后(25.6±2.4)mm,随访三月为(25.4±2.2)mm(与术前比较,P<0.05);Cobb角由术前的(22.5±3.6)°到术后(10.5±3.0)°随访三月为(10.3±2.8)°(与术前比较,P<0.05)。结论:经椎弓根基底外侧的单侧穿刺锥体成形术可有效恢复骨质疏松性椎体压缩性骨折椎体高度、缓解疼痛,是一种安全、有效的治疗方法,值得推广。Objective： To evaluate the tharapeutic effect of Unipedicular vertebroplasty guided by fluoroscopy in osteoporotic spinal compression fractures. Methods： Fourteen patients （12 females and 2 males） with 18 vertebral compression fractures underwent Unipedicular vertebroplasty. They were mean aged 67.3 years （60-83 years）. The fracture segment was within T8-L3 （12 thoracical vertebrae, 6 lumbar vertebrae）. Under the guidance of C-arm fluoroscopy, bone marrowbiopsy needle was inserted percutaneously viavertebral pedicle intothe fractured vertebral body. Polymethylmethacrylate （PMMA） was then injected into the fractured vertebrae. Visual analogue scale （VAS）, the anteriore vertebral height, the middle vertebral heights were evaluated 3 days before and after Unipedicular vertebroplasty and in the follow-up period. Results： Unipedicular vertebroplasty was successful in 14 cases （18 vertebrae）. VAS was sharply decreased from 8.5±0.3 to 2.2±0.2 at day 3 after Unipedicular vertebroplasty （P〈0. 001） ; and was 2.1 ± 2.4 at final follow-up. The height of anterior column of the vertebrae increased from 13.6 ± 2. 2 mm to 24.50 ±2.20 mm and was 24.0±2.0 mm at final follow-up （P〈0.01） ,the middle vertebral heights increased from 14.2±2.1 mm preoperatively to 25.6±2.4 mm, was 25.4±2.2 mm at final follow-up （P〈0.01）, and the kyphosis Cobb angles were corrected from 22.5°±3.6° preoperatively to 10.5°±3.0° postoperatively and was 10.2°±2.8°mm at final followup （P〈0.01）. Conclusions： Unipedicular vertebroplasty is an effective mini-invasive technique for osteoporotic spinal compression fractures and can be accomplished safely wnder C-arm single-plane fluoroscopy in most cases.

关 键 词：椎体压缩骨折 单侧穿刺 胸腰段 骨水泥 

分 类 号：R687.3[医药卫生—骨科学]