术前三维重建CT扫描在椎体成形术中应用  

Value of preoperative 3D-CT reconstruction in percutaneous vertebroplasty

作　　者：牟罡 任伟剑[2] MU Gang REN Wei-jian(Fengcheng Orthopedic Hospital, Fengcheng 118100, China)

机构地区：[1]凤城市骨科医院,辽宁凤城118100 [2]沈阳军区总医院骨科,辽宁沈阳110016

出　　处：《临床军医杂志》2016年第10期1003-1005,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨术前三维重建CT技术在胸腰椎骨折经皮椎体成形术(PVP)中的应用价值。方法回顾性分析沈阳军区总医院骨科自2014年1月至2015年12月收治的骨质疏松性胸腰椎压缩性骨折50例患者(50个椎体)的临床资料。按术前是否行三维CT重建,分为非三维重建组(A组,23例)和三维重建组(B组,27例)。采用疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)等对患者的临床疗效进行评价。比较两组手术时间,并观察有无骨水泥渗漏、肺栓塞、脊髓压迫加重等并发症情况。结果两组患者术后3 d及末次随访时的VAS评分、ODI均较本组术前明显改善(P<0.05)。而且,两组患者术后3 d及末次随访时的VAS评分、ODI比较,差异均无统计学意义(P>0.05)。但B组的手术时间(30.45±6.12)min明显低于A组的(40.21±7.35)min,差异有统计学意义(P<0.05)。A组有3例出现骨水泥渗漏,而B组无骨水泥渗漏。结论术前三维CT重建扫描应用于胸腰椎骨折PVP,能缩短手术时间、减少并发症等优点,临床效果满意。Objective To investigate the value of preoperative 3D-CT reconstruction in percutaneous vertebroplasty（ PVP） for the treatment of thoracolumbar fractures. Methods Clinical data of 50 patients（ 50 vertebrae） with thoracolumbar fractures treated by PVP from January 2014 to November 2015 in the General Hospital of Shenyang Military Command,were retrospectively analyzed in this study. All cases were divided into two groups,according to preoperative designs without 3D-CT reconstruction（ Group A,23 cases） or with 3D-CT reconstruction（ Group B,27 cases）. Visual analog scale（ VAS） scores and Oswestry disability index（ ODI） values were performed in all cases before and after surgery. Operation time and clinical outcome were compared between the two groups.Results At 3 days postoperatively and last follow-up,both VAS scores and ODI values were modified in all cases when compared with those of preoperation（ P〈0. 05）. While,there were no statistical differences between the two groups（ P〉0. 05）. Surgery cost less time in Group A than that of Group B [（ 30. 45 ± 6. 12） minutes versus（ 40. 21 ± 7. 35） minutes,P〈0. 05]. Bone cement leakage was observed in 3 cases in Group A,but non case in Group B. Conclusion Preoperative 3D-CT reconstruction in PVP for the treatment of thoracolumbar fractures could obtain good clinical effect with the advantages of less operation time and fewer postoperative complications.

关 键 词：三维CT重建 胸腰椎骨折 经皮椎体成形术 骨水泥 

分 类 号：R687[医药卫生—骨科学]