改良椎弓根旁单侧穿刺椎体成形术治疗胸腰椎压缩性骨折  

Treatment of Thoracolumbar Vertebral Compression Fracture with Modified Paripedicular Unilateral Percutaneous Vertebroplasty

作　　者：张韬[1] 袁中山[1] 夏良政[1] 邓英虎[1] 余涛[1] 周明昊 Zhang Tao;Yuan Zhongshan;Xia Liangzheng;Deng Yinghu;Yu Tao;Zhou Minghao(Spine Group,Department of Orthopedics,Tongling People's Hospital,Tongling 244000,China)

机构地区：[1]安徽省铜陵市人民医院骨科脊柱病区,安徽铜陵244000

出　　处：《实用骨科杂志》2022年第1期12-15,40,共5页Journal of Practical Orthopaedics

摘　　要：目的前瞻性分析侧孔骨水泥注入套管结合改良椎弓根旁单侧穿刺椎体成形术治疗胸腰段椎体压缩性骨折的有效性与安全性。方法收集2019年1月至2020年12月,符合本研究纳入标准的胸腰段(T_(10)~L_(2))骨质疏松性压缩性骨折(osteoporotic vertebral compression fracture,OVCF)患者40例,其中男3例,女37例;年龄61~86岁,平均(71.1±7.06)岁。骨折椎体分布如下:三椎体1例,双椎体3例,单椎体36例,其中T_(10)椎体4例,T_(11)椎体4例,T_(12)椎体19例,L_(1)椎体15例,L_(2)椎体3例。记录术前、术后1d、术后末次随访时各时间点的疼痛视觉模拟评分(visual analogue scale,VAS),并进行统计学分析比较术前及术后各时间点的差异。结果所有手术均顺利进行,手术时间20~65min,平均(31.25±9.31)min。患者均获随访,随访时间10~24个月,平均(17.70±4.10)个月。所有患者均未发生手术相关并发症。腰痛VAS术前为(6.42±0.58)分,术后1d为(2.40±0.49)分,末次随访为(1.62±0.48)分。术后各时间点VAS较术前改善明显,差异有统计学意义(P<0.05)。结论经侧孔骨水泥注入套管结合改良椎弓根旁单侧穿刺椎体成形术治疗老年胸腰段椎体压缩性骨折安全、有效、微创。Objective To prospectively analyze the efficacy and safety of lateral bone cement cannulation combined with modified parapedicular unilateral percutaneous vertebroplasty for thoracolumbar vertebral compression fractures.Methods Data of 40cases of osteoporotic vertebral compression fracture(OVCF)in thoracic and lumbar segment(T_(10)~L_(2))meeting the inclusion criteria of this study were collected from January 2019to December 2020,and the patients including 3males and 37females.The age ranged from 61to 86years,with an average of(71.1±7.06)years.The distribution of fractured vertebrae was as follows:1trivertebrae,3bivertebrae,and 36single vertebrae,including 4 T10vertebrae,4T11vertebrae,19T12vertebrae,15L1vertebrae,and 3L2vertebrae.The visual analogue scale(VAS)of pain at each time point was recorded before surgery,1dafter surgery and at the last postoperative follow-up,and statistical analysis was performed to compare the differences between the preoperative and postoperative time points.Results All the operations were performed successfully,and the operation time was 20~65 min,with an average of(31.25±9.31)min.All patients were followed up for 10~24months,with an average of(17.70±4.10)months.No surgical complications occurred in any of the patients.Low back pain VAS score was(6.42±0.58)points before surgery,(2.40±0.49)points 1dafter surgery,and(1.62±0.48)points at the last follow-up.VAS scores at all postoperative time points were significantly improved compared with those before surgery,and the difference was statistically significant(P<0.05).Conclusion The treatment of thoracolumbar vertebral compression fracture with lateral bone cement cannulation combined with modified parapedicular unilateral percutaneous vertebroplasty is a safe,effective and minimally invasive surgical method for thoracolumbar vertebral compression fracture in the elderly.

关 键 词：胸腰椎压缩性骨折 椎体成形术 侧孔套管 

分 类 号：R683.2[医药卫生—骨科学]