网袋成形术治疗A3型骨质疏松椎体骨折的中期临床疗效分析  

The midterm result of the clinical effect of percutaneous vesselplasty for type A3 osteoporotic vertebral fractures

作　　者：张顺聪[1] 郭丹青[1] 于淼[2] 邓再冲 李永贤[3] ZHANG Shun-cong;GUO Dan-qing;YU Miao;DENG Zai-chong;LI Yong-xian(Spine Dept.The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510405;Foshan Hospital of Chinese Medicine,Foshan,Guangdong 528000;Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510405)

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

出　　处：《赣南医学院学报》2018年第9期895-898,927,共5页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：广东省科技厅课题(2016A020215137);广东省佛山市科技计划项目(2015AB00352)

摘　　要：目的:研究网袋成形术(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:回顾性纳入我科2016年1～12月接受经皮球囊后凸成形术(BKP)及VP的病例资料,共纳入33例患者,其中网袋组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)月,球囊组(14. 1±5. 4)月。VP与BKP相比,VP组整体骨水泥渗漏率显著低于BKP组(P <0. 05),但椎管内渗漏、静脉丛渗漏率无显著差异,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意义(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意义(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 effects of vesselplasty(VP)for 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 separated into two groups depending on surgery type.In the VP group,there were 14 patients with 11 female and 3 male and an average age of 71.8±10.6 years old.In the BKP group,there were 19 patients with 16female and 3 male and an average age of 72.7±9.3 years old.The VAS scores,ODI and X-ray parameters were recorded before surgery,1 day after surgery and the final follow-up.Results:The follow-up time ranged from 12 to 19 months.The mean time of VP group was 13.1±3.5 months,and of BKP was 14.1±5.4 months.VP had significant lower cement leakage than BKP group.Compared with BKP,no significant difference was observed in injected cement volume,adjacent vertebral fracture rate,the change of vertebral cobb angle,restoration rate of anterior and middle height,the VAS score and the Oswestry Disability Index(ODI)at 1 day postoperative and the last follow-up(P>0.05).The Mean pain score and ODI vitally decreased postoperatively and at the last follow-up(P<0.05)in both groups.The cobb angle,anterior and middle heights were significantly improved at 1 d postoperative and the last follow-up,but no statistically intergroup differences.Conclusion:Compared with BKP,Vesselplasty could significantly decrease the cement leakage,and share the similar clinical effects with BKP for type A3 OVF.It could release pains and improve function,kyphosis,restore and maintain the height of augmented vertebra.

关 键 词：网袋成形 骨质疏松 胸腰椎椎体骨折 

分 类 号：R683.2[医药卫生—骨科学]