摘要
目的评估2种微创手术方式(经皮椎体成形术和经皮椎体后凸成形术)对骨质疏松性椎体骨折不愈合疗效的影响。方法本组24例(24椎)椎体骨折不愈合患者,均为女性。分成2组:A组12例(12椎),局麻下行经皮椎体成形术治疗。B组12例(12椎),局麻下行经皮椎体后凸成形术治疗。术前骨密度检查示:A、B组均存在重度骨质疏松。A、B组手术由同一组医生完成,术后予密固达及密盖息行规范抗骨质疏松治疗。比较2组手术前后患者主观满意度,骨水泥充填量及渗漏率,椎体前、中份高度,脊柱后凸角度等指标。结果 A、B组年龄、术前胸腰段后凸角度无统计学差异(P>0.05)。B组椎体复位效果优于A组(P<0.05);B组后凸改善优于A组(P<0.05);A组骨水泥渗漏7椎(58.3%),B组骨水泥渗漏3椎(25%),A组骨水泥渗漏率显著高于B组(P<0.01);A、B组患者的主观满意度无显著性差异(P>0.05)。结论对于骨质疏松性椎体骨折不愈合,经皮椎体成形术及经皮椎体后凸成形术均能有效缓解患者的胸腰背部疼痛。但前者术中骨水泥渗漏率发生风险较高,后者可获得较为满意的椎体复位效果。
Objective To evaluate and compare clinical results of two minimally invasive surgical approach （including PKP and PVP） on patients of vertebral compression fractures nonunion. Methods 24 cases of patients （24 vertebras） were female, which were divided into 2 groups： group A （n = 12） , which performed PVP with local anesthesia; group B （n =43） , which performed PKP with local anesthesia. Preoperative examination showed that bone mineral density of group A and B was severe osteoporosis. The operation of group A, B was completed by the same team of doctors; patients were therefore correspondingly Aclasta and Miacalcic line of anti- osteoporosis treatment. Comparison of subjective satisfaction （VAS score） , bone cement leakage rate, anterior, middle vertebral body height, kyphosis angle of 2 groups before and after surgery. The effect of vertebral compression fractures nonunion with two minimally invasive surgical approaches was observed. Results Group A and B of age and preoperative thoracolumbar kyphosis angle was no significant difference. Vertebra reduction of group B was more effective than group A; Group B of vertebral kyphosis was better than group A; Group A of 7 vertebral bone cement leakage （58.3%） and Group B of 3 vertebral bone cement leakage 25% ） and Group A of bone cement leakage rate was higher than group B ; Subjective satisfaction with group B showed no significant difference. Conclusion Minimally invasive surgical approach on patients of vertebral compression fractures nonunion of PKP compared with PVP, the former can provide a better vertebra reduction, the risk of bone cement leakage rate of the latter is more than the former, and the ~ubjective satisfaction of the latter is similar to the former.
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2013年第9期973-976,980,共5页
Chinese Journal of Osteoporosis
基金
中国博士后科学基金面上项目资助(2012M511781)
