单、双侧穿刺椎体成形术治疗椎体骨质疏松性压缩骨折效果比较  

Comparison of the Effect of Unilateral and Bilateral Puncture Vertebroplasty in the Treatment of Osteoporotic Vertebral Compression Fractures

作　　者：李宏达 贾鹏 夏群 井万里[1] 石涛 刘未 LI Hong-da;JIA Peng;XIA Qun;JING Wan-li;SHI Tao;LIU Wei(Department of Orthopedics,Tianjin First Central Hospital,Tianjin 300192;Department of Emergency Traumatology,Tianjin First Central Hospital,Tianjin 300192)

机构地区：[1]天津市第一中心医院骨科,天津300192 [2]天津市第一中心医院急创科,天津300192

出　　处：《中国医疗器械信息》2023年第15期112-115,共4页China Medical Device Information

摘　　要：目的:比较老年人椎体骨质疏松性压缩性骨折行单、双侧穿刺椎体成形术治疗临床效果。方法:回顾性分析2021年1月~2022年12月天津市第一中心医院骨科诊治的单节段胸腰椎骨质疏松性压缩骨折老年患者90例,其中男性19例,女性71例;年龄54~97岁,平均(73.3±9.1)岁。40例采用侧开口套管经单侧椎弓根穿刺行经皮后凸成形术(单侧组),50例采用传统末端开口套管经双侧椎弓根穿刺行经皮后凸成形术(双侧组)。比较两组手术时间、术中出血量、骨水泥弥散情况、骨水泥渗漏情况、疼痛视觉模拟评分。结果:90例患者均顺利完成手术,两组患者均未发生骨水泥渗漏或栓塞病例,两组患者术后疼痛较术前明显缓解,差异具有统计学意义(P<0.05),两组患者术后1d疼痛组间比较单侧组疼痛更轻,差异具有统计学意义(P<0.05),而术后1个月组间比较差异无统计学意义(P>0.05)。单侧组较双侧组手术时间更短、术中出血更少(P<0.05)。结论:单侧与双侧穿刺经皮后凸成形术治疗老年人椎体骨质疏松性压缩骨折均能获得良好临床效果,单侧穿刺经皮后凸成形术在手术时间、术中出血量、术后疼痛改善方面具有优势。Objective:To compare the clinical effects of unilateral and bilateral puncture vertebroplasty in the treatment of osteoporotic vertebral compression fractures in the elderly.Methods:A total of 90 elderly patients with single-segment thoracolumbar osteoporotic compression fractures treated in the Department of Orthopedics,Tianjin First Central Hospital from January 2021 to December 2022 were retrospectively analyzed,including 19 males and 71 females.The age ranged from 54 to 97 years,with an average of(73.3±9.1)years.In the unilateral group,40 patients underwent percutaneous kyphoplasty through unilateral pedicle puncture with lateral opening trocar,and in the bilateral group,50 patients underwent percutaneous kyphoplasty through bilateral pedicle puncture with traditional terminal opening trocar.The operation time,intraoperative blood loss,diffusion of bone cement,number of bone cement leakage,and visual analogue scale(VAS)of pain were compared between the two groups.Results:90 patients were successfully completed the operation,there were no cases of bone cement leakage or embolism in the two groups.The postoperative pain of the two groups was significantly relieved compared with that before the operation,and the difference was statistically significant(P<0.05).Postoperative 1d pain between the two groups was less severe in the unilateral group,the difference was statistically significant(P<0.05).There was no significant difference between the two groups at 1 month after operation(P>0.05).The unilateral group had shorter operation time and less intraoperative blood loss than the bilateral group(P<0.05).Conclusion:Both unilateral and bilateral percutaneous kyphoplasty can achieve good clinical results in the treatment of osteoporotic vertebral compression fractures in the elderly.Unilateral percutaneous kyphoplasty has advantages in operation time,intraoperative blood loss and postoperative pain relief.

关 键 词：老年 椎体 骨质疏松性压缩骨折 椎体后凸成形术 

分 类 号：TH781[机械工程—仪器科学与技术]