单双侧经皮椎体后凸成形术治疗胸腰段骨质疏松性椎体压缩骨折  

Treatment of thoracolumbar osteoporotic vertebral compression fractures by unilateral or bilateral percutaneous kyphoplasty

作　　者：邹德波[1] 周东生[2] 张凯宁[1] 吴莹光[1] 张虎[1] 任延军[1] 杨允[1] 

机构地区：[1]山东大学附属千佛山医院骨科,济南250014 [2]山东大学附属省立医院创伤骨科,济南250021

出　　处：《中国矫形外科杂志》2012年第2期108-111,共4页Orthopedic Journal of China

摘　　要：[目的]探讨单、双侧经皮椎体后凸成形术治疗胸腰段骨质疏松性椎体压缩骨折的方法及其效果。[方法]回顾性分析胸腰段骨质疏松性椎体压缩骨折患者117例共169个椎体,分为单侧穿刺组和双侧穿刺组,比较治疗前后两组患者的手术时间、出血量、骨水泥灌注量、疼痛强度视觉模量评分、Oswestry功能障碍指数、骨折椎体高度恢复、后凸矫正程度、骨水泥渗漏率,评价治疗效果。[结果]两组患者的手术时间、出血量和骨水泥灌注量均存在显著性差异(P<0.05)。术后两组患者的疼痛强度视觉模量评分、Oswestry功能障碍指数明显改善,伤椎高度恢复,椎体后凸部分矫正,均较术前有统计学意义(P<0.05),随访期间疼痛指数无加重;但两组间比较,治疗效果及骨水泥渗漏率无显著性差异(P>0.05)。[结论]单、双侧经皮椎体后凸成形术均可有效治疗骨质疏松性椎体压缩骨折,单侧组具有手术时间短、创伤小等优点。[ Objective ] To explore the methods and clinical outcomes of the treatment of thoracolumbar osteoporotic vertebral compression fractures by unilateral or bilateral percutaneous kyphoplasty. [ Method] We retrospectively analyzed 117 patients（ 169 vertebrae） with thoracolumbar osteoporotic vertebral compression fractures. The patients were divided into unilateral punctured and bilateral punctured groups. The operation time, bleeding, cement quantity, visual analogue scale, Oswestry dysfunctional index,recovery of the fractured vertebrae height and the local kyphotic angle of the two groups were evaluated and their clinical effects were compared. [ Result] The operation time, bleeding and the cement quantity were significantly different （P 〈0.05）between groups. However,we found both groups greatly improving its visual analogue scale and Oswestry dysfunctional index after operation. The fractured vertebrae height and the local kyphotic angle were minimized（P 〈 0. 05 ）. All patient had no increasing pain during post surgery survey. There were no significant differences between groups（P 〉 0.05 ） in operation effect and cement leakage. [ Conclusion] Either unilateral or bilateral percutaneous kyphoplasty could treat osteoporotic vertebral compression fractures effectively. However, there are some advantages in the unilateral punctured group, such as shorter operation time and lesser injury.

关 键 词：骨质疏松 脊柱骨折 后凸成形术 治疗效果 

分 类 号：R687.3[医药卫生—骨科学]