三种椎弓根入路行椎体后凸成形术的骨水泥弥散分布及临床对比研究  

The distribution of bone cement and clinical comparison study on the three method of pedicular approach to percutaneous kyphoplasty

作　　者：翁科捷[1] 钟志刚[1] 张育锋[1] 邱雪立[1] 刘成[1] 刘昌易 

机构地区：[1]广东省汕头市中心医院骨科,515031

出　　处：《山西医药杂志》2016年第13期1501-1503,共3页Shanxi Medical Journal

基　　金：广东省汕头市科技计划(汕府科[2014]62号-39)

摘　　要：目的比较椎体后凸成形术(PKP)中采取3种不同的穿刺方法,术后骨水泥的弥散情况及临床疗效的差异。方法收集2013年11月至2015年9月我院收治的66例单节段胸腰椎骨质疏松性压缩骨折采取椎体后凸成形术的患者进行回顾性研究,平均随访6个月以上;按不同方法分为单侧组(18例)、双侧同平面组(28例)及双侧交叉平面组(20例),记录术前、术后1d以及末次随访时的疼痛视觉模拟评分(VAS),根据CT图像计算术后骨水泥弥散容积及弥散的平衡性,记录骨水泥渗漏及邻近椎体骨折情况等。结果所有患者的术后1d及终末VAS评分较术前均明显改善,双侧入路组的术后1d的VAS评分均优于单侧入路组(P<0.05),远期则差异无统计学意义(P>0.05);双侧组骨水泥弥散容积、骨水泥弥散的平衡度均优于单侧组(P<0.05);双侧组2组间各项指标比较差异均无统计学意义(P>0.05)。结论 PKP是治疗脊柱骨质疏松性压缩性骨折的有效微创手术,单侧及双侧穿刺均能获得良好的临床效果。双侧穿刺入路能更有效地缓解术后早期的疼痛,能使骨水泥弥散分布更加均匀充分。Objective To compare the curative effect and the distribution of bone cement on the three method of pedicular approach to percutaneous kyphoplasty for osteoporotic vertebral compression fractures（OVCF）.Methods The clinical data of 66 cases with single segmental OVCF operated by PKP from November 2013 to September 2015 in our hospital were retrospectively analyzed.All of them received more than 6months′follow-up.They were divided into three groups on the basis of unilateral or of transpedicular operations.The unilateral group included 18 patients,the same plane bilateral group included 28 patients and the biplane bilateral group included 20 patients.Observation and analysis were analyzed preoperatively and postoperatively.Observations included：visual analog pain score（VAS）,the proportion and balance from the distribution of bone cement which were computed by CT images.The bone cement leakage and the adjacent vertebral failure after vertebroplasty were recorded.Results The VAS scores in 1day after surgery and last follow-up were significantly improved compared with preoperative（P〈0.05）;the VAS scores in 1day after surgery from both bilateral groups were significantly improved compared with unilateral group（P〈0.05）,but there were no statistical difference of VAS from last follow-up in the three groups（P〉0.05）.The proportion and balance from the distribution of bone cement in both bilateral groups were significantly improved compared with unilateral group（P〈0.05）.There were no statistical difference between both bilateral groups compared with all data（P〉0.05）.Conclusion Both unilateral or bilateral transpedicular approach of PKP can achieve excellent clinical outcomes for OVCF,the bilateral transpedicular approach of PKP can achieve sufficient and balanced distribution of bone cement in the vertebrae body.It also can improve the pain from early postoperative significantly compared with unipedicular approach.

关 键 词：椎体后凸成形术 骨质疏松压缩骨折 骨水泥分布 

分 类 号：R687.3[医药卫生—骨科学]