侧开口推杆在经皮椎体成形术中应用的初步报告  

Application of Side-opening Cannulas in Percutaneous Vertebroplasty:A Preliminary Report

作　　者：叶林强[1] 江晓兵[1] 姚珍松[1] 唐晶晶[1] 丁金勇[1] 张顺聪[1] 晋大祥[1] 梁德[1] Ye Linqiang;Jiang Xiaobing;Yao Zhensong(Department of Spinal Surgery,The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong 510405,China)

机构地区：[1]广州中医药大学第一附属医院脊柱骨科,510405

出　　处：《医学研究杂志》2021年第6期102-106,共5页Journal of Medical Research

基　　金：广东省医学科学技术研究基金资助项目(A2017024);广东省中医药局科研项目(20182030)。

摘　　要：目的探讨侧开口推杆在经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折(OVCFs)的临床效果。方法回顾性分析2016年3月~2017年2月笔者医院的125例单节段OVCFs行PVP治疗的患者临床资料,采用直开口和侧开口推杆注入骨水泥分别是66例(前开口推杆组)和59例(侧开口推杆组)。统计分析两组患者骨水泥渗漏、骨水泥在骨折区域填充情况及胸腰背疼痛视觉模拟评分(VAS)。结果前开口推杆组B型和C型渗漏发生率明显高于侧开口推杆组(P<0.05),但两组S型渗漏比较,差异无统计学意义(P>0.05);直开口推杆组有9例(13.6%)出现骨水泥在骨折区域填充不佳,侧开口推杆组骨折区域均得到充足骨水泥填充,差异有统计学意义(P<0.05);把前开口推杆组分成填充充分亚组和填充不佳亚组,填充不佳亚组、填充充分亚组和侧开口推杆组术前及术后6个月VAS比较差异无统计学意义(P>0.05);3组术后2天VAS及术后6个月VAS均较术前明显降低(P<0.05),术后6个月VAS较术后2天进一步明显降低(P<0.05);填充充分亚组与侧开口推杆组术后2天VAS比较差异无统计学意义(P>0.05),但填充不佳亚组术后2天VAS明显高于填充充分亚组和侧开口推杆组(P<0.05)。结论与采用前开口推杆实行PVP治疗OVCFs比较,侧开口推杆更能使骨水泥精准分布在骨折区域及与周围松质骨充分嵌插,并且可以显著减少B型和C型骨水泥渗漏,提高疗效及安全性。Objective To investigate the effect of side-opening cannulas on percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fractures(OVCFs).Methods Totally 125 cases of single level OVCFs treated by PVP in our hospital between March 2016 and February 2017 were reviewed.Front-opening cannulas was used in 66 cases(front-opening cannulas group)while side-opening cannulas in 59 cases(side-opening cannulas group).Cement leakage,cement distribution in the fracture area and VAS before surgery,at two days after surgery,at six months after surgery were collected for statistical analysis.Results Type B and C cement leakage rate in front-opening cannulas group was significant higher compared with side-opening cannulas group(P<0.05)while significant difference could not be found in type S cement leakage(P>0.05).Insufficient cement distribution in fracture area was observed in no patient of side-opening cannulas group while 9 patients(13.6%)of front-opening cannulas group(P<0.05).Front-opening cannulas group was further divided into sufficient subgroup and insufficient subgroup on basis of cement distribution.No significant differences in VAS before surgery and at six months after surgery existed among insufficient subgroup,sufficient subgroup and side-opening cannulas group(P>0.05).VAS at two days after surgery and six months after surgery was significantly decreased compared with before surgery(P<0.05).VAS at six months after surgery was further significantly decreased compared with at two days after surgery(P<0.05).However,VAS at two days of insufficient subgroup was significantly higher compared with sufficient subgroup and side-opening cannulas group(P<0.05)while differences between sufficient subgroup and side-opening cannulas group could not be found(P>0.05).Conclusion Compared with PVP using front-opening cannulas for OVCFs,PVP using side-opening cannulas could better make cement distribute in the fracture area and interdigitate with surrounding cancellous bone,and decrease type B and C cement leakage to i

关 键 词：经皮椎体成形术 骨质疏松性椎体压缩骨折 侧开口推杆 

分 类 号：R681[医药卫生—骨科学]