单侧与双侧椎弓根入路椎体成形术治疗高龄骨质疏松性椎体压缩骨折的临床疗效比较  

Comparison of Clinical Effects between Unipedicular and Bipedicular Approach to Percutaneous Vertebroplasty for Senior Osteoporosis Vertebral Compressive Fractures

作　　者：李菊根[1] 廖壮文[1] 范子文[1] 黄彦[1] 

机构地区：[1]广州医学院第二附属医院骨外科,广州510260

出　　处：《中国微创外科杂志》2013年第6期531-533,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨单侧与双侧椎弓根入路经皮穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折的临床疗效及价值。方法回顾分析2007年12月～2011年2月我院56例获得6个月以上随访的女性骨质疏松性单个椎体压缩性骨折的临床资料,其中采用单侧椎弓根入路经皮穿刺椎体成形术治疗30例,双侧椎弓根入路经皮穿刺椎体成形术治疗26例,比较2组患者手术时间、骨水泥填充量、X线照射次数及术后VAS评分。结果单侧组手术时间(25±6)min显著少于双侧组(45±5)min(t=-13.426,P=0.011)。单侧组骨水泥渗漏率10.0%(3/30),与双侧组3.8%(1/26)无显著差异(χ2=0.138,P=0.710)。单侧组术中X线曝光(10.5±2.5)次,显著少于双侧组(19.4±3.0)次(t=-12.110,P=0.000)。2组术后24 h、术后6、12个月VAS评分无统计学差异(P>0.05)。结论单侧与双侧椎弓根入路经皮穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折均能取得良好效果。单侧穿刺方法手术时间短,X线暴露次数少;双侧入路穿刺方法手术操作相对简单。Objective To compare the clinical efficacy of unipedicular and bipedicular approach to percutaneous vertebroplasty（PVP） in the treatment of osteoporotic vertebral compressive fracture. Methods A retrospective study was carried out on 56 female patients with single osteoporotic vertebral compressive fractures from December 2007 to February 2011. Thirty cases were treated by PVP via a unipedicular approach （ unipedicular group） and 26 eases were treated by bipedicular approach （ bipedicular group）. The operation time, amount of bone cement injected, frequency of X-ray exposure and postoperative VAS score were compared. Results In the unipedicular group, the mean operation time was （25 ± 6） min, which was significantly shorter than that in the bipedicular group[（45 ±5）min, t = -13.426,P=0.011]. The leakage rate of bone cement was 10.0% （3/30） in the unipedicular group and 3.8% （1/26） in the bipedicular group. There was no significant difference between the two groups （X^2 = 0. 138,P =0. 710）. The X-ray exposure frequency in the unipedicular group was （10.5 ± 2.5） times, which was significantly less than that in the bipedicular group[ （ 19.4 ± 3.0） times, t = - 12. 110,P = 0. 000 ]. No statistical difference could be found in VAS assessment between the two groups 24 h, 6 months, and 12 months after the surgery between the two groups （ P 〉 0. 05 ）. Conclusions Unipedicular and bipedicular approaches to PVP for senior osteoporosis vertebral compressive fracture have the same clinical effects. The unipedicular approach can shorten operation time and reduce X-ray exposure, while the bipedicular approach requires simpler procedure.

关 键 词：骨质疏松 压缩性骨折 经皮椎体成形术 

分 类 号：R687.3[医药卫生—骨科学]