经皮单侧与双侧椎弓根入路椎体后凸成形术的疗效对比研究  

Clinical outcomes comparison of unipedicular kyphoplasty versus bipedicular vertebroplasty treating for osteoporotic vertebral compression fracture

作　　者：曹新峰[1] 彭国栋[1] 彭明[1] 马晓程[1] 

机构地区：[1]青岛市市立医院骨科暨青岛市微创脊柱外科中心,266011

出　　处：《中国医师进修杂志》2011年第32期17-19,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的比较经皮单侧与双侧椎弓根入路球囊扩张椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的疗效。方法对64例（68椎）骨质疏松性椎体压缩性骨折患者，根据手术方法不同，分为单侧入路组（33例）与双侧入路组（31例）。比较两组手术前后视觉模拟评分法（VAS）评分、Cobb角、手术时间方面的差异。结果术前、术后24h、术后3个月，单侧入路组VAS评分分别为（8．42±1．33）、（2．21±1．67）、（2．09±1．58）分，Cobb角分别为（31．24±9．12）°、（14．21±9．21）°、（14．43±9．36）°；双侧入路组VAS评分分别为（8．36±1．52）、（2．13±1．80）、（2．00±1．71）分，Cobb角分别为（30．84±8．77）°、（13．94±8．87）°、（14．07±9．87）°，两组患者术后24h及术后3个月VAS评分、Cobb角均较术前明显改善（P〈0．01）；且两组同一时段VAS评分、Cobb角比较差异无统计学意义（P〉0．05）。单侧人路组和双侧入路组手术时间分别为（45．00±8．76）、（72．00±9．32）min，差异有统计学意义（P〈0．01）。结论经皮单侧椎弓根入路椎体后凸成形术与经皮双侧椎弓根入路椎体后凸成形术相比，具有创伤小、手术时间短、患者与术者接受的x线辐射小等优点，且可以达到和经皮双侧椎弓根人路椎体后凸成形术相似的疗效。Objective To compare the clinical outcome of unipedicular versus bipedicular vertebroplasty treating for osteoporotic vertebral compression fracture. Methods Sixty-four patients （68 vertebra） were divided into two groups by treated methods：unipedicular kyphoplasty group （33 cases） and bipedicular vertebroplasty group （31 cases）. The Cobb angle and vasual analogue pain scale （VAS） were measured preoperatively and postoperatively. The operation time was recorded. Compared the Cobb angle, VAS and the operation time between two groups. Results Of unipedicular kyphoplasty group preoperative, 24 hours and 3 months after operation, VAS were （8.42 ±1.33）, （2.21±1.67）, （2.09 ±1.58） scores, the Cobb angle were （31.24±9.12）° , （14.21 ±9.21）° , （14.43 ±9.36）° ;while those of bipedicular vertebroplasty group were （8.36 ±1.52）, （2.13 ± 1.80）, （2.00 ± 1.71） scores and （30.84± 8.77）°, （ 13.94 ±8.87）° , （ 14.07 ± 9.87）° .VAS and the Cobb angle of both groups at 24 hours and 3 months after operation were lower than those preoperative（P 〈 0.01 ）. VAS and the Cobb angle of both groups were similar at the same time preoperatively and postoperatively （P 〉0.05）. The operation time of unipedicular kyphoplasty group and bipedicular vertebroplasty was （45.00 ± 8.76）, （72.00 ± 9.32） min, respectively, there was statistically significant difference between two groups （P 〈 0.01 ）. Conclusions Compared with the bipedicular vertebroplasty,the advantages of unipedicular kyphoplasty are as follows：less trauma,less operation time and less X-rays rediation accepted of the patient and the operator. And it has the similar clinical outcome with the bipedicular vertebroplasty.

关 键 词：脊柱骨折 COBB角 椎体后凸成形术 

分 类 号：R683[医药卫生—骨科学]