单侧与双侧经皮穿刺椎体成形术治疗老年骨质疏松性胸腰椎压缩性骨折的效果比较  

Comparison of unilateral versus bilateral percutaneous vertebroplasty for elderly thoracolumbar compression fractures

作　　者：王延明 徐明杰[1] 王三木 张立贵[1] 张鹏飞[1] Wang Yanming;Xu Mingjie;Wang Sanmu;Zhang Ligui;Zhang Pengfei(Ward I,Department of Orthopedics,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第五附属医院骨科一病区,郑州450052

出　　处：《中国实用医刊》2025年第2期24-27,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨单侧与双侧经皮穿刺椎体成形术(PVP)治疗老年骨质疏松性胸腰椎压缩性骨折(OVCF)的临床效果。方法回顾性抽取2020年2月至2023年5月于郑州大学第五附属医院行手术治疗的OVCF患者92例,按照穿刺路径将其分为A组(48例,予以单侧PVP)和B组(44例,予以双侧PVP)。比较两组手术相关指标、伤椎高度、伤椎后凸Cobb角、术后疼痛[视觉模拟评分法(VAS)]、Oswestry功能障碍指数(ODI)、骨水泥弥散距离、骨水泥渗漏率、并发症发生情况。结果A组骨水泥注入量少于B组(P<0.05),手术时间、X线暴露时间短于B组(P<0.05)。术后,两组伤椎高度高于术前(P<0.05),伤椎后凸Cobb角小于术前(P<0.05),ODI、VAS评分低于术前(P<0.05),但两组间上述指标比较差异未见统计学意义(P>0.05)。B组骨水泥弥散距离大于A组,骨水泥渗漏率低于A组(P<0.05)。B组并发症发生率(4.54%,2/44)与A组(12.50%,6/48)比较,差异未见统计学意义(P>0.05)。结论对于老年OVCF,单侧穿刺PVP具有骨水泥注入量少、手术时间及X线暴露时间短的优势,双侧穿刺PVP具有骨水泥弥散距离更优、骨水泥渗漏率更低的优势,两种术式的治疗效果及安全性相当。Objective To investigate the clinical effects of unilateral and bilateral percutaneous vertebroplasty(PVP)on elderly osteoporotic thoracolumbar vertebral compression fractures(OVCF).Methods Ninety-two patients with OVCF who underwent surgery in the Fifth Affiliated Hospital of Zhengzhou University from February 2020 to May 2023 were selected retrospectively,and they were divided into the group A(48 cases,treated by unilateral PVP)and the group B(44 cases,treated by bilateral PVP)according to the puncture approach.The operation-related indexes,postoperative pain assessed by visual analogue scale(VAS),Oswestry dysfunction index(ODI),injured vertebral height,Cobb angle of kyphosis,bone cement diffusion distance,bone cement leakage rate,and incidence of complication were compared between the two groups.ResultsThe dose of bone cement injection in the group A was less than that in the group B(P<0.05),while the operation duration and X-ray exposure time in the group A were shorter than those in the group B(P<0.05).After surgery,the injured vertebral heights in the two groups increased,the Cobb angle of kyphosis decreased,while the ODI and VAS scores lowered compared with these indexes before surgery(P<0.05);but there was no significant difference in the above indexes between the two groups after surgery(P>0.05).The diffusion distance of bone cement in the group B was greater than that in the group A,and the leakage rate of bone cement in the group B was lower than that in the group A(P<0.05).There was no significant difference in the incidence of complication between the group B(4.54%,2/44)and the group A(12.50%,6/48),P>0.05.Conclusions For elderly OVCF,unilateral puncture PVP has the advantages of less cement injection,shorter operation duration,and shorter X-ray exposure time;while bilateral puncture PVP has the advantages of better diffusion distance and lower cement leakage rate;and the two methods have comparable safety.

关 键 词：骨质疏松 胸腰椎压缩性骨折 老年 经皮穿刺椎体成形术 单侧 双侧 

分 类 号：R68[医药卫生—骨科学]