单、双侧经皮椎体成形术治疗骨质疏松性椎体压缩骨折疗效比较  

The Effect Comparison of the Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures via the Unilateral and Bilateral Transpedicular Approach

作　　者：郭振鹏[1] 温国宏[2] 李小琴[3] 尚晖[1] 李兵奎[1] 邓磊[1] 杨棋[1] 

机构地区：[1]湖北省十堰市太和医院湖北医药学院附属医院骨三科,湖北十堰442000 [2]湖北省十堰市太和医院湖北医药学院附属医院医务处,湖北十堰442000 [3]湖北省十堰市太和医院湖北医药学院附属医院肝胆胰诊疗中心,湖北十堰442000

出　　处：《中国现代手术学杂志》2015年第6期439-442,共4页Chinese Journal of Modern Operative Surgery

基　　金：湖北省自然科学基金项目(W2014ZT292)

摘　　要：目的比较单双侧经皮椎体成形术（percutaneous vertebroplasty,PVP）治疗骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fractures,OVCF）的临床疗效。方法回顾性分析2008年3月~2014年3月在我院行PVP治疗的153例单节段OVCF患者的临床资料,所有患者术后均随访满1年,按手术入路分为单侧组91例（经单侧椎弓根入路）和双侧组62例（经双侧椎弓根入路）。结果单侧组和双侧组的手术时间分别为（20.22±2.34）min和（40.35±3.45）min,骨水泥注入量分别为（5.58±0.55）ml和（7.21±0.43）ml;单侧组手术时间及骨水泥注入量均明显少于双侧组（P〈0.05）,但两组骨水泥渗漏率比较无统计学差异（15.4%VS 19.4%,P〉0.05）。两组术前VAS评分、ODI指数、后凸Cobb角、椎体高度及SF-36评分比较均无统计学差异（P〉0.05）;两组术后及末次随访时VAS评分、ODI指数、后凸Cobb角、椎体高度及SF-36评分均较术前明显改善（P〈0.05）,但组间比较无统计学差异（P〉0.05）。结论单侧和双侧经椎弓根入路行PVP治疗OVCF均可取得满意效果,但前者手术操作简单,创伤小,值得临床推广应用。Objective To compare the curative effect of percutaneous vertebroplasty （PVP） in the treat- ment of the osteoporotic vertebral compression fractures （OVCF） via unilateral transpedicular approach and bilat- eral transpedicular approach. Methods The clinical data of 153 cases with single segmental OVCF from March 2008 to March 2014 underwent PVP and followed up more than 1 year were analyzed retrospectively. They were divided into unilateral group （n = 91 ） and bilateral group （n = 62） according to uni- or bilateral transpedicular approach. Results The operation time and bone cement injection volume of the unilateral group was （20.22 ± 2.34 min） and （5.58 ± 0.55 ） ml respectively, both were lower than （40.35 ± 3.45 ） rnin and （7.21 ± 0.43 ） ml of bilateral group respectively, and there was statistical difference between two groups （P 〈 0.05） ; but the bone cement leakage rate of the unilateral and bilateral group was 15.4% （ 14/91 ） and 19.4% （12/62） respectively, and no statistical difference was found between two groups （ P 〉 O. 05 ）. The preoperative VAS score, ODI index, kyphotic Cobb angle, vertebral height and SF-36 score had no statistical difference between two groups （P 〉 0. 05） ;All the VAS score, ODI index, kyphotic Cobb angle, vertebral height and SF-36 score were improved obviously after the surgery and at the time of the last follow-up than those of preoperation in the two groups （ P 〈 0. 05 ）, but there was no statistical difference between two groups （P 〉 0.05）. Conclusion Both unilateral transpedicular approach or bilateral transpedicular approach of PVP can achieve satisfactory results for OVCF, but the unilateral transpedicular approach is imple and mini-trauma, and worthy of clinical popularization and application.

关 键 词：椎体压缩性骨折 骨质疏松 椎体成形术 手术入路 

分 类 号：R687.3[医药卫生—骨科学]