双侧入路与经上关节突横突单侧入路PVP手术治疗腰椎骨质疏松性椎体压缩骨折的疗效比较  

Comparison of the effects of unilateral or bilateral percutaneous vertebroplasty for lumbar osteoporotic vertebral compression fractures

作　　者：郑科[1] 刘艺明[1] 王晓陆[1] 郁贤舜[1] 单涛 杜怡斌[1] ZHENG Ke;LIU Yi-ming;WANG Xiao-lu;YU Xian-shun;SHAN Tao;DU Yi-bin(Department of orthopedics,Hefei first people's Hospital,Hefei,Anhui 230000)

机构地区：[1]合肥市第一人民医院脊柱外科,安徽合肥230000

出　　处：《颈腰痛杂志》2021年第4期490-493,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：合肥市卫健委2019年应用医学研究项目(编号:2020001)。

摘　　要：目的分析经上关节突横突基底单侧入路与传统双侧入路注射骨水泥经皮椎体成形术治疗腰椎骨质疏松性椎体压缩骨折(osteoporosis vertebral compression fracture,OVCF)的疗效。方法自2018年1月~2018年12月采用PVP手术治疗52例腰椎OVCF患者,根据手术入路分为两组:单侧组30例,经上关节突横突基底单侧入路;双侧组22例,采用传统双侧入路。术后随访12~18个月,对两组患者的手术疗效进行比较。结果两组患者受伤后至手术时间,以及术前、术后1 d、术后1个月及末次随访时的伤椎前缘高度、Cobb角和VAS评分、骨水泥渗漏率差异均无统计学意义(P>0.05);两组患者手术时间、骨水泥用量差异有统计学意义(P<0.05)。结论两种入路穿刺行PVP手术治疗腰椎OVCF均安全有效,但上关节突横突基底单侧入路穿刺的手术时间短、骨水泥注入量少,是一种理想的替代方法。Objective To analyze the curative effect of percutaneous vertebroplasty(PVP)through unilateral approach and traditional bilateral approach in the treatment of osteoporotic vertebral compression fracture(OVCF).Methods From January 2018 to December 2018,52 patients with lumbar OVCF were treated with PVP.According to the surgical approach,they were divided into two groups:unilateral group(n=30),unilateral approach through the base of superior articular process transverse process;In bilateral group,22 cases were treated by traditional bilateral approach.The patients were followed up for 12~18 months,and the curative effects of the two groups were compared.Results There were no significant differences in the time from injury to operation,the height of anterior edge of injured vertebrae,Cobb angle,VAS score and bone cement leakage rate before operation,1 day after operation,1 month after operation and the last follow-up between the two groups(P>0.05);There were statistically significant differences in operation time,bone cement dosage and the number of patients in the two groups(P<0.05).Conclusion PVP through both approaches is safe and effective in the treatment of lumbar OVCF,but the unilateral approach through the base of the transverse process of the superior articular process is an ideal alternative because of its short operation time and the amount of bone cement injected.

关 键 词：经横突根部单侧穿刺 经皮椎体成形术 骨质疏松 腰椎压缩性骨折 骨水泥 

分 类 号：R687.3[医药卫生—骨科学]