椎旁肌入路经皮椎体成形术手术疗效探讨  

Efficacy of percutaneous kyphoplasies through the approach between para-vertebral muscle

作　　者：邬亚明[1,2] 尹毅 单辉强 黄伟 

机构地区：[1]苏州大学,江苏苏州215006 [2]江苏省昆山市第一人民医院,江苏昆山215300

出　　处：《中国当代医药》2013年第2期54-55,57,共3页China Modern Medicine

摘　　要：目的探讨经皮椎体成形术结合经椎旁肌入路手术方式治疗骨质疏松性椎体压缩骨折的临床效果与安全性。方法 2009年6月～2010年6月本院采用经皮穿刺椎体成形术治疗骨质疏松性椎体压缩骨折57例,随机选取22例采用传统手术治疗,35例接受结合椎旁肌入路的手术治疗,临床随访2年,观察治疗效果。结果通过围术期疗效观察,发现经椎旁肌入路手术与传统手术相比,术后疼痛视觉模拟评分(visual analogue scale,VAS)差异无统计学意义,但在手术时间、出血量、射线暴露次数等方面差异具有统计学意义(P<0.05)。截至2012年6月,共55例患者获得随访,平均随访时间为28.9个月(24～36个月),随访患者的骨折椎体均获得良好愈合,未发生椎体高度进行性丢失,无骨水泥的移位,两组远期疗效无明显差异。结论结合椎旁肌入路行椎体成形术治疗胸腰椎骨质疏松性压缩骨折具有手术操作简单、创伤小、术后恢复快等优点,为椎体成形技术提供了另一种思路。Objective To study the clinical effect and safety of percutaneous vertebroplasty by the paraspinal muscle surgery approach for the treatment of osteoporotic compression fractures. Methods From June 2009 to June 2010, 57 patients with osteoporotic compression fractures were treated in our hospital, all the patients were randomly divided into two groups. 22 cases were treated with traditional surgical method, 35 patients were given percutaneous vertebroplasty by the paraspinal muscle surgery approach. They were followed up for 2 years and the effect was observed. Results Through comparison between the two groups, the results confirmed that the new approach had obvious advantage over traditional method in operative time, blood loss, exposure times in ray, and the difference was statistical significant （P 0.05）, although visual analogue scale（VAS） was almost the same between the two approaches. Till June 2012, 55 patients were available and all got follow up from 24 to 36 months （average of 28.9 months）. Neither progressive loss of vertebral height nor boneless cement shift had occurred in two groups. There is no significant difference between the two sets of long-term efficacy. Conclusion This technique of operative treatment through the approach between para-vertebral muscle is much less invasive and applicable, which can reduce the blood loss, accelerate the rehabilitation simultaneously.

关 键 词：椎体成形术 椎旁肌入路 骨质疏松 压缩性骨折 

分 类 号：R683[医药卫生—骨科学]