双侧双平面穿刺与单侧经横突基底部穿刺椎体成形术治疗胸腰段骨质疏松性椎体压缩骨折的疗效比较  

Comparison of the effects of bilateral biplane puncture and unilateral vertebroplasty through the base of transverse process in the treatment of thoracolumbar osteoporotic vertebral compression fractures

作　　者：郁贤舜[1] 刘艺明[1] 郑科[1] 吕文[1] 王晓陆[1] YU Xian-shun;LIU Yi-ming;ZHENG Ke;LYU Wen;WANG Xiao-lu(the First People's Hospital of Hefei,Hefei,Anhui 230000,China)

机构地区：[1]合肥市第一人民医院,安徽合肥230000

出　　处：《颈腰痛杂志》2022年第1期68-71,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的比较双侧双平面穿刺与单侧经横突基底部穿刺椎体成形术治疗胸腰段骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的疗效。方法收集合肥市第一人民医院脊柱外科自2018年9月~2020年5月收治的60例胸腰段OVCF患者,均为单椎体新鲜骨折。依据术中穿刺路径的不同,将60例患者分为两组:对照组28例,行单侧经横突基底部穿刺椎体成形术;观察组32例,行双侧双平面穿刺椎体成形术。对两组患者术前和术后随访期间的VAS评分及伤椎矫正情况进行比较。结果两组患者的骨水泥注入量无显著差异(P>0.05);但观察组手术时间和术中X线透视次数等指标数据均显著高于对照组,差异有统计学意义(P<0.05)。与术前相比,两组患者术后1 d、1个月、3个月、6个月及1年的VAS评分均显著降低(P<0.05),但组间差异无统计学意义(P>0.05)。术后1d、1个月时,两组患者的伤椎前缘高度、矢状位Cobb角均获一定程度的矫正,但组间差异无统计学意义(P>0.05);术后3个月、6个月及1年时,对照组的伤椎前缘高度、矢状位Cobb角矫正度有所丢失,而观察组尚不明显,且组间差异有统计学意义(P<0.05)。结论双侧双平面穿刺椎体成形术治疗胸腰段OVCF患者,在恢复椎体高度及纠正脊柱力线方面更具优势;但双侧穿刺显著增加了手术时间和术中X线透视次数。Objective To compare the efficacy of bilateral biplane puncture and unilateral vertebroplasty through the base of transverse process in the treatment of thoracolumbar osteoporotic vertebral compression fracture(OVCF).Methods Sixty patients with thoracolumbar OVCF treated in the spinal surgery department of the First People's Hospital of Hefei from September 2018 to May 2020 were collected.All of them were fresh fractures of single vertebral body.According to the different puncture paths,60 patients were divided into two groups:28 patients in the control group underwent unilateral vertebroplasty through the base of transverse process;32 cases in the observation group underwent bilateral biplane puncture vertebroplasty.VAS scores and correction of injured vertebrae were compared between the two groups before operation and during postoperative follow-up.Results There was no significant difference in the amount of bone cement injection between the two groups(P>0.05),but the operation time and intraoperative X-ray fluoroscopy times in the observation group were significantly higher than those in the control group(P<0.05).Compared with before operation,the VAS scores of the two groups decreased significantly at 1 day,1 month,3 months,6 months and 1 year after operation(P<0.05),but there was no significant difference between the two groups(P>0.05).At 1 day and 1 month after operation,the anterior height of the injured vertebra and the Cobb angle in sagittal position were corrected to a certain extent,but there was no significant difference between the two groups(P>0.05).At 3 months,6 months and 1 year after operation,the anterior height of injured vertebrae and the correction of kyphosis Cobb angle in the control group were lost,but it was not obvious in the observation group,and the difference between the two groups was statistically significant(P<0.05).Conclusion Bilateral biplane puncture vertebroplasty has more advantages in restoring vertebral height and correcting spinal force line in the treatment of thoracolumba

关 键 词：双侧双平面 经横突基底部 经皮椎体成形术 骨质疏松性胸腰段椎体压缩骨折 

分 类 号：R683.2[医药卫生—骨科学]