G型臂X线机引导下经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折  

Percutaneous kyphoplasty treatment of osteoporotic vertebral compression fracture under the guidance of G-arm X-ray machine

作　　者：刘军[1] 郝申申 刘志斌[1] 康凯[1] 杜璠[1] 王飞[1] 刘延雄[1] 贺永进[1] Liu Jun;Hao Shenshen;Liu Zhibin;Kang Kai;Du Fan;Wang Fei;Liu Yanxiong;He Yongjin(Department of Spinal Surgery,Yanan University Affiliated Hospital,Yanan 716000,China)

机构地区：[1]延安大学附属医院脊柱外科,716000

出　　处：《中国综合临床》2018年第6期520-523,共4页Clinical Medicine of China

基　　金：陕西省社会发展科技攻关项目（2015SF115）;延安市科技惠民计划项目（2016HM-10-03）

摘　　要：目的 探讨应用G型臂X线机引导下经皮椎体后凸成形术（percutaneous kyphoplasty,PKP）在治疗骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fractures,OVCF）的临床应用价值.方法 回顾性收集延安大学附属医院2016年6月至2017年6月82例（94椎体）PKP治疗的OVCF患者的病历资料.39例（44椎体）采用G型臂X线机引导下实施PKP,记为G臂组.43例（50椎体）采用C型臂X线机引导下实施PKP,记为C臂组.记录两组的手术时间、术中透视次数、骨水泥漏例数,术前术后伤椎前缘高度、伤椎后凸Cobb角、视觉模拟评分、Oswestry功能障碍指数评分.结果 G臂组与C臂组手术时间、术中透视次数比较差异均有统计学意义[手术时间：（31.6±5.2）min与45.8±6.7）min,术中透视次数：（9.5±2.3）次与18.7±3.5）次;t值分别为-10.64、-13.91,P均〈0.05],骨水泥漏例数比较差异无统计学意义（P〉0.05）.G臂组与C臂组对比术后与术前伤椎前缘高度、伤椎后凸Cobb角、视觉模拟评分、Oswestry功能障碍指数评分差异均有统计学意义（t值分别为-3.41与-3.28、6.67与7.66、26.63与25.75、10.41与11.90,P均〈0.05）,而组间对比差异均无统计学意义（P均〉0.05）.结论 采用G型臂X线机引导下PKP治疗OVCF,可以较传统C型臂X线机引导下PKP显著缩短手术时间,减少术中透视次数,降低手术操作难度,增加手术安全性.Objective To explore the clinical application value of percutaneous kyphoplasty （ PKP ） under the guidance of G arm X ray machine in the treatment of osteoporotic vertebral compression fracture （OVCF）. Methods The medical records of eighty-two patients （94 vertebral bodies） with OVCF treated with PKP were collected retrospectively. Thirty-nine cases （ 44 vertebral bodies ） were guided by G-arm X-ray machine to implement PKP,which were recorded as G-arm group. Forty-three cases （50 vertebral bodies） were guided by C-arm X-ray machine to carry out PKP,which were recorded as C-arm group. The operation time, intraoperative fluoroscopy times, bone cement leakage cases, preoperative and postoperative anterior height of injured vertebrae,Cobb angle of injured vertebrae,visual analogue scale scores and Oswestry disability index of the two groups were recorded. Results There was significant difference in operation time and intraoperative fluoroscopy times between the G-arm group and C-arm group （the operation time：（31. 6±5. 2） vs. （45. 8±6. 7） min,the intraoperative fluoroscopy times： （9. 5±2. 3） times vs. （18. 7±3. 5） times,t=-10. 64,-13. 91,P〈0. 05） ,while there was no significant difference in the number of bone cement leakage （ P〉0. 05） . Compared postoperative and preoperative anterior height of injured vertebrae, Cobb angle of injured vertebrae, visual analogue scale scores and Oswestry disability index scores of G-arm group and C-arm group respectively, the differences were significant （ t=-3. 41 vs. -3. 28, 6. 67 vs. 7. 66, 26. 63 vs. 25. 75 and 10. 41 vs. 11. 90, P〈0. 05）. There was no significant difference between the two groups （P〉0. 05）. Conclusion The treatment of OVCF with PKP guided by G-arm X-ray machine could significantly shorten operation time, reduce the intraoperative fluoroscopy times and the operative difficulty,and increase operation safety than PKP guided by traditional C-arm X-ray machine.

关 键 词：骨质疏松性椎体压缩性骨折 经皮椎体后凸成形术 G型臂X线机 C型臂X 线机 

分 类 号：R687.3[医药卫生—骨科学]