靶点注射经皮椎体后凸成形术治疗胸腰椎骨松性压缩骨折的疗效  

Curative effect of target injection percutaneous kyphoplasty on thoracolumbar osteoporotic vertebral compression fractures

作　　者：张文通 黄晋旺 张雷 米尔萨力江·亚森 洪伟祥 夏庆 Zhang Wentong;Huang Jinwang;ZhangLei;MiersalijiangoYasen;Hong Weixiang;Xia Qing(Department of Orthopaedics,Xiamen Branch,Zhongshan Hospital,Fudan University,Xiamen,Fujian,360015,P.R.China;Department of Orthopaedics,Zhongshan Hospital,Fudan University,Shanghai,200030,P.R.China)

机构地区：[1]复旦大学附属中山医院厦门医院骨科,厦门360015 [2]复旦大学附属中山医院骨科,上海200030

出　　处：《老年医学与保健》2020年第5期795-797,共3页Geriatrics & Health Care

基　　金：2019年厦门市科技计划项目赞助(3502Z20199034)。

摘　　要：目的评价细针穿刺靶点穿刺注射行经皮椎体后凸成形术治疗胸腰椎骨质疏松性压缩性骨折的早期疗效。方法回顾复旦大学附属中山医院厦门医院骨科2018年4月至2020年1月60例胸腰椎骨松性压缩骨折患者,分别采用4.2 mm直径穿刺系统常规穿刺法及3.5 mm穿刺系统细针穿刺靶点注射法行单节段双侧穿刺椎体后凸成形术。评价手术时间、注入骨水泥量、术前、术中及术后的疼痛视觉模拟(VAS)评分、椎体前缘高度复位率等指标,比较两组的疗效差异。结果两组患者年龄、腰椎骨密度、术前椎体高度平均值无统计学差异(P=0.266,P=0.390,P=0.612,),B组患者平均手术时间(40.8 min)小于A组患者(44.8 min,P=0.006)。两组患者骨水泥注入量及复位率,术前、术中、术后疼痛感VAS评分均无统计学差异(P=0.058,P=0.631,P=0.496,P=0.159,P=0.969)。结论采用细针穿刺靶点注射行经皮椎体后凸成形术治疗胸腰椎OVCF与常规穿刺手术相比,疗效相当,但使用小直径穿刺系统操作方便,更快速完成手术。Objective To evaluate the early curative effect of percutaneous kyphoplasty with fine needle aspiration target point puncture and injection for the treatment of thoracolumbar osteoporotic vertebral compression fractures(OVCF).Methods 60 patients with thoracolumbar OVCF admitted to our hospital from April 2018 to January 2020 were analyzed retrospectively.The conventional puncture method of 4.2 mm diameter puncture system(group A)or the fine needle puncture target injection method of 3.5 mm puncture system(group B)were used to perform single-segment bilateral kyphoplasty.The operation time,the amount of bone cement injected,the preoperative,intraoperative and postoperative pain visual simulation(VAS)score,the anterior edge height reduction rate of the vertebral body and other indicators were evaluated,and the curative effect was compared between the two groups.Results There was no significant difference in age,BMD of lumbar vertebrae and average preoperative vertebral height between the two groups(P=0.266,P=0.390,P=0.612),but the operation time of group B(40.8 min)was significantly shorter than that of group A(44.8 min,P=0.006).There was no significant difference in the amount of bone cement injection,reduction rate,and the preoperative,intraoperative and postoperative pain VAS scores between the two groups(P=0.058,P=0.631,P=0.496,P=0.159,P=0.969).Conclusion Percutaneous kyphoplasty for thoracolumbar OVCF with fine needle puncture target injection has the same curative effect as the conventional puncture operation,but the small diameter puncture system is convenient to operate and complete the operation more quickly.

关 键 词：椎体后凸成形术 骨质疏松性椎体压缩骨折 视觉疼痛评分 疗效 

分 类 号：R687.3[医药卫生—骨科学]