定向球囊技术在经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折中的应用  

Application of directional balloon technique in the treatment of osteoporotic vertebral compression fracture with percutaneous kyphoplasty

作　　者：李志强[1] 顾伟[1] 卫晓恩[1] LI Zhi-qiang;GU Wei;WEI Xiao-en(Second Department of Orthopedics,Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属曙光医院骨二科,上海200021

出　　处：《中国临床医学》2021年第3期472-475,共4页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨定向球囊技术在经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗胸腰椎单椎体骨质疏松性压缩性骨折中的应用价值。方法:选择2018年5月至2020年3月上海中医药大学附属曙光医院收治的胸腰椎单椎体骨质疏松性压缩性骨折患者122例,分别接受传统PKP(对照组,n=61)和定向球囊PKP(试验组,n=61)。比较2组患者术后骨水泥渗漏情况、视觉模拟评分(VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)及骨折椎体楔形角、Cobb角。结果:与对照组相比,试验组手术时间缩短、X线透视次数减少(P<0.001)。试验组总水泥渗漏率低于对照组(P=0.013)。2组患者骨折椎体手术前后楔形角、Cobb角差异无统计学意义;手术后骨折椎体楔形角及Cobb角均较手术前减小(P<0.001)。试验组手术后1 d及3 d的VAS评分低于对照组(P<0.05);2组手术后5 d的VAS评分差异无统计学意义。2组患者术前ODI差异无统计学意义;术后ODI均较手术前减小(P<0.001)。结论:定向球囊PKP术能有效减少胸腰椎单椎体骨质疏松性压缩性骨折术中透视次数、缩短手术时间、降低术后水泥渗漏率及减轻患者术后疼痛,值得在临床推广应用。Objective:To explore the application value of directional balloon technology in the treatment of osteoporotic vertebral compression fracture with percutaneous kyphoplasty(PKP).Methods:A total of 122 patients with osteoporotic vertebral compression fracture of the thoracolumbar vertebrae were selected Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine from May 2018 to March 2020.61 patients in the control group received traditional PKP and 61 patients in the experimental group received directional balloon PKP.The postoperative bone cement leakage,visual analogue scale(VAS)and Oswestry disability index(ODI),wedge angle,and Cobb angle of patients were compared.Results:The operation time was shorten and the number of X-ray fluoroscopy was less in the experimental group than those in the control group(P<0.001).The total cement leakage rate in the experimental group was lower than that in the control group,the difference was statistically significant(P=0.013).There was no statistical difference in the wedge angle and Cobb angle between the two groups before and after the operation,and the wedge angle and Cobb angle decreased after surgery than before surgery in the two groups(P<0.001).The VAS score in the experimental group was lower than those in the control group 1 d and 3 d after surgery(P<0.05),and there was no significant difference in VAS score between the two groups 5 d after surgery.There was no significant difference in the ODI score between the two groups before surgery,and it decreased in the two groups after surgery(P<0.001).Conclusions:Compared with traditional PKP,directional balloon PKP could effectively reduce the number of intraoperative fluoroscopy,shorten the operation time,reduce the postoperative cement leakage rate,and relieve the postoperative pain of patients with osteoporotic compression fracture of the thoracolumbar vertebrae,so it is worthy of clinical application.

关 键 词：定向球囊技术 经皮椎体后凸成形术 骨质疏松 椎体压缩性骨折 

分 类 号：R683.2[医药卫生—骨科学]