可弯曲调节装置辅助经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效  

The effect of percutaneous kyphoplasty assisted by flexible adjusting device on osteoporotic vertebral compression fracture

作　　者：段登海 袁媛 申云杰 任定宝 李垠莹 杨仕成 赵汉武 王恩斌[1] DUAN Deng-hai;YUAN Yuan;SHEN Yun-jie;REN Ding-bao;LI Yin-ying;YANG Shi-cheng;ZHAO Han-wu;WANG En-bin(Dept of Orthopaedics and Traumatology,Baoshan Hospital of Traditional Chinese Medicine,the First Affiliated Hospital of Baoshan College Traditional Chinese Medicine,Baoshan,Yunnan 678000,China)

机构地区：[1]保山市中医医院,保山中医药高等专科学校第一附属医院骨伤科,云南保山678000

出　　处：《临床骨科杂志》2023年第4期466-469,共4页Journal of Clinical Orthopaedics

基　　金：云南省保山中医药高等专科学校科技项目(编号:2021k006)。

摘　　要：目的 探讨可弯曲调节装置辅助经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)的疗效。方法 采用可弯曲调节装置辅助PKP治疗20例OVCF患者。记录术中透视次数、骨水泥注入量、手术时间、骨水泥渗漏情况。采用椎体前缘高度百分比、疼痛VAS评分、Cobb角评价临床疗效。结果 患者均获得随访,时间2~10个月。患者均单侧穿刺1次。术中透视12~21次,骨水泥注入量2~5 ml/椎,手术时间25~36 min。无骨水泥渗漏情况发生。疼痛VAS评分:末次随访2~5(2.6±1.5)分,与术后的2~5(3.4±2.3)分比较差异无统计学意义(P>0.05)。椎体前缘高度百分比、Cobb角:术后、末次随访均明显优于术前(P<0.05),末次随访与术后比较差异均无统计学意义(P>0.05)。末次随访时患者腰椎功能均恢复至伤前,无明显腰痛不适。结论 可弯曲调节装置辅助PKP治疗OVCF仅需单侧穿刺1次,操作简单、安全性高,较小内倾角就能实现整个椎体骨水泥的均匀弥散分布,能迅速减轻疼痛、恢复椎体高度、改善腰椎功能。Objective To investigate the efficacy of percutaneous kyphoplasty(PKP)with flexible adjusting device in the treatment of osteoporotic vertebral compression fracture(OVCF).Methods PKP assissted with flexible adjusting device was used to treat 20 patients with OVCFs.The following data were recorded,including the items of intraoperative fluoroscopy and the volume of bone cement injection during operation,operation time and bone cement leakage status.The percentage of vertebral anterior margin height,pan VAS,kyphotic Cobb angles were used to evaluate the clinical efficacy.Results All patients were followed up for 2~10 months.All patients underwent unilateral puncture once.During the operation,fluoroscopy was performed 12~21 times,and the volume of bone cement injected was 2~5 ml per vertebra.The operation time was 25~36 min.Pain VAS was 2~5(2.6±1.5)points at the last follow-up,compared with 2~5(3.4±2.3)points after operation,there was no statistical difference(P>0.05).The percentage of anterior margin height and Cobb angle of the vertebra:at the postoperation and the last follow-up,they were significantly better than before operation(P<0.05),and there was no statistical difference between the last follow-up and postoperation(P>0.05).At the last follow-up,the lumbar function of the patients was restored to the pre-trauma,and there was no obvious lumbago discomfort.Conclusions For the treatment of OVCFs with PKP,only one unilateral puncture is needed.The procedure is simple and safe,and the smaller inclination angle can obtain an uniform distribution of bone cement throughout the vertebrae,which can relieve pain fastly,restore the height of the vertebrae and improve the function of the lumbar spine.

关 键 词：可弯曲调节装置 经皮椎体后凸成形术 骨质疏松性椎体压缩骨折 骨水泥分布 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学] R681[医药卫生—临床医学]