摘要
目的：探讨单侧与双侧高粘度骨水泥经皮椎体成形术治疗骨质疏松性椎体压缩骨折的疗效比较。方法：选取老年性骨质疏松性椎体压缩性骨折患者223例,共280个椎体。随机分为2组,单侧组共115例,154个椎体,双侧组共108例,126个椎体。单侧组为单侧穿刺骨水泥注射过椎体中线,双侧组为双侧穿刺骨水泥注入,治疗3d后比较两组患者手术时间、手术前后视觉模拟疼痛评分、椎体高度恢复率、椎体后凸Cobb角改善及术后骨水泥渗漏病例评定患者的临床疗效。结果：单侧穿刺组与双侧穿刺组手术时间分别为（30.84±1.95）min,（41.28±1.94）min,比较差异有统计学意义（P〈0.001）。单侧组与双侧组椎体平均高度恢复率为分别为94.26%±3.51%和96.35%±3.22%,比较差异无统计学意义（P〉0.05）;单侧组与双侧组视觉模拟疼痛评分分别为1.41±0.12和1.12±0.13,比较差异无统计学意义（P〉0.05）;单侧组与双侧组术后Cobb角恢复分别为13.70°±1.61°和13.31°±1.25°,比较差异无统计学意义（P〉0.05）;单侧组渗漏病例远低于双侧组,分别为5.84%和12.69%,比较差异有统计学意义（P〈0.05）。所有患者术后获得3-48个月（平均16个月）随访,其中1例出现神经根症状,所有患者未出现感染、肺栓塞等并发症。结论：单侧与双侧经椎弓根经皮椎体成形术治疗骨质疏松性椎体压缩骨折均可取得满意的止痛效果,且前者具有手术时间短、术后并发症发生率低等优点。
Objective：To discuss the curative effect of unilateral and bilateral high viscosity bone cement in treatment of osteoporotic vertebral compression fractures.Methods：223cases of senile OVCF were selected,a total of 280 vertebrae.The patients were randomLy divided into 2groups according to the puncture site,154 cases of 115 vertebral bodies in unilateral group and 126 cases of 108 vertebral bodies in bilateral group.In the unilateral group,bone cement was injected from one side and through the midline of the vertebral body while the cement was injected from both sides in the bilateral group.3days after treatment,the operation time,visual analogue pain score,vertebral height recovery rate,Cobb angle of vertebral body and cement leakage rate were compared between the two groups.Results：There was significant difference in the operation time（30.84±1.95 min vs 41.28±1.94min）between the two groups（P〈0.001）.There was no significant difference in the average recovery rate of vertebrae height（94.26% ±3.51% vs 96.35% ±3.22%）,visual analog pain scores（1.41±0.12 vs 1.12±0.13）and postoperative Cobb angle recovery（13.70°±1.61°vs 13.31°±1.25°）between the two groups（P〈0.05）.The leakage rate in the unilateral group was much lower than that in the bilateral group（5.84% vs12.69%）,and there was statistical difference（P〈0.05）.All patients were followed up for 3to 48 months（mean 16months）.1patient had symptom of nerve root and all the patients had no complications such as infection and pulmonary embolism.Conclusion：Both unilateral and bilateral PKP in the treatment of OVCF can obtain satisfactory analgesic effect,and the former has the advantages of short operation time and low incidence of postoperative complications.
出处
《中国中医骨伤科杂志》
CAS
2016年第5期29-32,共4页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
基金
卫生部医药卫生科技发展研究中心基金资助(W2012ZT15)
关键词
高黏度骨水泥
椎体成形术
骨质疏松
椎体压缩性骨折
high viscosity bone cement
vertebroplasty
oste oporosis
vertebral compressive fractures
