不同透视方法行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比较  

Comparison of the effects of percutaneous kyphoplasty using different fluoroscopy methods on osteoporotic vertebral compression fractures

作　　者：杨雯栋[1] 黄瑛 杨启远[1] 雷超 YANG Wen-dong;HUANG Ying;YANG Qi-yuan;LEI Chao(Dept of Spine Surgery,the Third People′s Hospital of Mianyang City,Sichuan Mental Health Center,Mianyang,Sichuan 621000,China)

机构地区：[1]绵阳市第三人民医院·四川省精神卫生中心脊柱外科,四川绵阳621000

出　　处：《临床骨科杂志》2024年第4期471-475,共5页Journal of Clinical Orthopaedics

摘　　要：目的比较不同透视方法行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。方法将56例行PKP治疗的OVCF患者根据术中透视方法不同分为A组(术中采用DynaCT透视,29例)和B组(术中采用C臂机透视,27例)。记录两组手术时间、骨水泥注入量、单侧穿刺率、骨水泥渗漏率、疼痛VAS评分、伤椎高度百分比、Cobb角及并发症发生情况。结果患者均获得随访,时间1~1.5年。手术时间、骨水泥注入量、单侧穿刺率两组比较差异均无统计学意义(P>0.05)。骨水泥渗漏率A组低于B组(P<0.05)。疼痛VAS评分、伤椎高度百分比及Cobb角:术后3 d及末次随访两组均较术前改善(P<0.05),末次随访与术后3 d比较差异均无统计学意义(P>0.05),两组间比较差异均无统计学意义(P>0.05)。两组术后均无脊髓神经损伤、肺栓塞、伤椎再发骨折及骨水泥移位等并发症发生。结论与C臂机比较,术中在DynaCT引导下行PKP治疗OVCF具有精准、安全、高效的优点。Objective To compare the efficacy of percutaneous kyphoplasty(PKP)with different fluoroscopy methods for treatment of osteoporotic vertebral compression fractures(OVCF).Methods The 56 cases of OVCFs patients treated with PKP were divided into group A(29 cases were used DSA-DynaCT fluoroscopy during the operation)and group B(27 cases were adopted with intraoperative C-arm machine fluoroscopy),according to different intraoperative fluoroscopy methods.Operation time,bone cement injection volume,unilateral puncture rate,bone cement leakage rate,pain VAS,percentage of injured vertebral height,Cobb angle and complications were recorded in the two groups.Results All patients were followed up for 1~1.5 years.There were no statistical differences in operation time,bone cement injection volume and unilateral puncture rate(P>0.05).The bone cement leakage rate of group A was lower than group B(P<0.05).Pain VAS,percentage of injured vertebral height and Cobb angles:at 3 d after surgery and the last follow-up,two groups were improved,compared with the preoperative results(P<0.05),and there were no statistical differences between the last follow-up and 3 d after surgery(P>0.05),while there were no statistical differences between the two groups(P>0.05).There were no complications such as spinal cord nerve injury,pulmonary embolism,recurrent fracture of injured vertebra and bone cement displacement in both groups.Conclusions Compared with C-arm X-ray machine,PKP treatment of OVCF guided by DynaCT has the advantages of accuracy,safety and high efficiency.

关 键 词：胸椎压缩性骨折 DYNACT 经皮椎体后凸成形术 

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