椎体成形手术单侧与双侧入路治疗老年性骨质疏松压缩性骨折的疗效分析  

Curative effects of unipedicular and bipedicular vertebroplasty in treating osteoporotic vertebral compression fractures in the elderly population

作　　者：刘春磊[1,2] 胡懿郃[1] 王贵清[2] 汤勇智[2] 王湘江[2] 侯瀚涛 

机构地区：[1]中南大学湘雅医院骨科,湖南长沙410008 [2]清远市人民医院骨科,湖南清远511500

出　　处：《西安交通大学学报（医学版）》2015年第6期857-861,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

摘　　要：目的探讨椎体成形术不同手术入路治疗老年性骨质疏松压缩性骨折的临床疗效。方法 2011年2月~2013年6月,98例老年性骨质疏松症并胸腰椎单节椎体压缩性骨折患者进行椎体成形术治疗,根据手术入路不同,随机分为单侧组（48例）和双侧组（50例）,前瞻性分析两组患者临床资料,包括性别、年龄、患者受伤到手术的时间、术后随访时间、手术时间,观察骨水泥注入量、椎体前缘高度压缩率（Lee法）,测量椎体后凸角度（Cobb角法）及并发症情况,术前、术后1d、术后1年分别采用VAS、ODI（视觉模拟评分法、Oswestry功能障碍指数）评分系统评估患者疼痛情况,比较两组的临床疗效。结果所有患者全部获得完整随访,两组中患者性别、年龄、患者受伤到手术的时间、术后随访时间差异无统计学意义（P〉0.05）。单侧组治疗48例,手术时间（34.87±5.91）min,骨水泥注入量（6.20±0.66）mL,术中发现骨水泥渗漏16例（33.3%）,椎体前缘高度压缩率改善（10.19±2.12）%,椎体后凸角度改善（13.23°±1.58°）;术后1d及1年VAS评分较术前分别改善（4.05±0.12）、（5.42±0.12）,术后1年VAS评分较术后1d改善（1.40±0.11）;术后1d及1年ODI评分较术前分别改善（35.46±1.89）%、（47.88±2.21）%,术后1年ODI评分较术后1d改善（11.42±0.24）%;术后邻近椎体再发骨折发生10例（20.9%）。双侧组治疗50例,手术时间（41.66±6.90）min,骨水泥注入量（4.88±0.52）mL,术中发现骨水泥渗漏9例（18.0%）,椎体前缘高度压缩率改善（10.48±1.43）%,椎体后凸角度改善（13.04°±2.03°）;术后1d及1年VAS评分较术前分别改善（4.06±0.11）、（5.30±0.10）,术后1年VAS评分较术后1d改善（1.34±0.08）;术后1d及1年ODI评分较术前分别改善（36.08±2.13）%、（47.54±1.97）%,术后1年ODI评分较术后1d改善（11.26±0.54）%;术后邻近椎体再发骨折6例（12.0%）。两组发生�Objective To investigate the clinical effect of the treatment of osteoporotic vertebral compression fractures in the elderly populationthrough different surgical approaches.Methods 98 cases with a single-level osteoporotic vertebral compression fracture in the elderly population were randomly divided into two groups from February 2011 to June 2013.48 patients were performed by percutaneous vertebroplasty（PVP）through unipedicular approach and 50 patients through bipedicular approachs.The clinical data of patients were prospectively analyzed and the clinical efficacy were compared between two groups using VAS（visual analogue scale method）and ODI（Oswestry disability index）in preoperative,postoperative 1 day and 1 year postoperatively.The data of age,gender,injury to the patients with operation time,postoperative follow-up time,operation time,bone cement injection,bone cement leakage and other complications were observed.Cobb angle,vertebral compression ration were observed by imaging data.Results All the cases were followed-up.There was no statistical difference in preoperative clinical data between the two groups（P〉0.05）.In unilateral group（48 cases）,the data of operation time,bone cement injection,bone cement leakage,Cobb angle improve,vertebral compression ration improve were（34.87±5.91）min,（6.20±0.66）mL,16 cases（33%）,（10.19±2.12）%,（13.23°±1.58°）and adjacent vertebral fractures was 10 cases（20.9%）.VAS score was respectively improved（4.05±0.12）,（5.42±0.12）in postoperative 1 day and 1 year than preoperative.VAS score was improved（1.40±0.11）in postoperative 1 year than 1 day.ODI score was respectively improved（35.46±1.89）%,（47.88±2.21）% in postoperative 1 day and1 year than preoperative.ODI score was improved（11.42±0.24）%in postoperative 1 year than1 day.In bilateral group（50 cases）.The data of operation time,bone cement injection,bone cement leakage,Cobb angle improve,vertebral compression ration improve were（41.66±6.90）min,�

关 键 词：椎体成形术 骨质疏松症 压缩性骨折 骨水泥 

分 类 号：R683.2[医药卫生—骨科学]