网袋成形术治疗骨质疏松性椎体爆裂骨折的临床观察  

Clinical Effect of Percutaneous Vesselplasty in Treatment of Osteoporotic Vertebral Burst Fractures

作　　者：于淼[1] 郭丹青[2] 张顺聪[2] 邓再冲 李永贤[3] YU Miao;GUO Danqing;ZHANG Shuncong;DENG Zaichong;LI Yongxian(Foshan hospital of Chinese Medicine,Foshan 528000,China)

机构地区：[1]佛山市中医院,广东佛山528000 [2]广州中医药大学第一附属医院,广东广州510405 [3]广州中医药大学,广东广州510405

出　　处：《现代医院》2018年第11期1646-1650,共5页Modern Hospitals

基　　金：佛山市科技计划项目(2015AB00352)

摘　　要：目的研究网袋成形术(Percutaneous Vesselplasty,VP)治疗AO分型A3型骨折(单一终板骨折伴后壁破损)的临床疗效。方法回顾性纳入2016年1月—2016年12月接受球囊后凸成形术(Balloon Kyphoplasty,BKP)及经皮网袋后凸成形术(Vesselplasty,VP)的病例资料,共纳入33名患者34椎。网袋组14例,球囊组19例,记录术前、术后1天、末次随访的VAS、及术前、末次随访的ODI及侧位X-ray参数。结果术后随访网袋组(13. 1±3. 5)个月,球囊组(14. 1±5. 4)个月。网袋组与球囊组相比,网袋组整体骨水泥渗漏率显著低于球囊组(P <0. 05),但两组组间椎管内渗漏、静脉丛渗漏率无统计学差异,水泥注入量、邻近节段骨折率、术后1天及末次随访X-ray参数、疼痛、功能改善均无统计学差异(P> 0. 05);两组术后1天及末次随访疼痛、功能障碍均较术前改善(P <0. 05);两组组内比较X-ray参数在术后1天、末次随访较术前明显增加(P <0. 05),而术后随访间无统计学差异(P>0. 05)。结论相较于BKP,VP可显著降低骨水泥渗漏风险,治疗A3型骨质疏松性椎体骨折的中期疗效与BKP类似,能明显缓解患者疼痛及改善功能活动,改善椎体后凸畸形,恢复及维持椎体高度。Objective To investigate the clinical effect of vesselplasty （VP） on type A3 （AO classification） osteoporotic vertebral fractures （OVF）. Methods 33 patients from Jan. 2016 to Dec. 2016 who accepted either VP or balloon kyphoplasty （BKP） were enrolled retrospectively and were divided into two groups depending on surgery type. In the VP group, there were 14 patients with 11 female and 3 male with an average age of 71.8±10.6 years old. In the BKP group, there were 19 patients with 16 female and 3 male with an average age of 72.7±9.3 years old. The values of VAS before operation and 1 day after operation, the values of ODI before opartioin and at last follow-up and the lateral X-ray parameters were recorded and compared between the two groups. Results The follow-up time ranged from 12 to 19 months, with the mean time of （13.1±3.5） months in VP group, and the time of BKP was （14.1±5.4） months. VP group had significantly lower cement leakage than BKP group. Compared with BKP, no significant difference was observed in injected cement volume, adjacent vertebral fracture rate, change of vertebral cobb angle, restoration rate of anterior and middle height, the VAS score and the Oswestry Disability Index （ODI） 1 day after operation and the last follow-up （ P 〉0.05）. The mean pain score and ODI vitally decreased after operation and at the last follow-up （ P 〈0.05） in both groups. The cobb angle, anterior and middle heights were significantly improved 1 d after operation and at the last follow-up, but there were no statistically differences between the two groups. Conclusion Compared with BKP, Vesselplasty significantly decreases the risk of cement leakage, and share the similar efficacy with BKP for type A3 OVF, releasing pains and improving function. It also can correct kyphosis, restore and maintain the height of augmented vertebra.

关 键 词：网袋成形 球囊 骨质疏松性椎体骨折 胸腰椎骨折A3型 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]