摘要
目的 探讨单、双侧椎弓根入路椎体成形术和椎体后凸成形术治疗骨质疏松性重度椎体压缩性骨折的疗效比较.方法 回顾性分析2013年1月至2016年8月本院收治的骨质疏松性重度椎体压缩性骨折并行椎体成形术或椎体后凸成形术治疗患者63例的临床资料,记录手术时间、术中X线透视时间、每节椎体注入骨水泥量、骨水泥渗漏情况、术前和术后的视觉模拟评分（VAS）、疼痛缓解率、SF-36健康调查简表,比较患者手术前、术后3d和末次随访时X线平片检查骨折椎体前壁、中心、后壁垂直高度和脊椎后凸角度变化.术后随访1年,记录患者新发椎体骨折时间.结果 对于骨质疏松性重度椎体压缩性骨折患者的治疗,单侧椎弓根入路椎体成形术在手术时间和X线透视时间上花费最少;但和双侧椎弓根入路椎体成形术一样,每节骨水泥量较椎体后凸成形术少;单双侧椎弓根入路椎体成形术骨水泥渗漏情况较多,且新发椎体骨折时间更短.3组患者术后VAS评分、生理健康综合评分和心理健康综合评分皆优于术前.单双侧椎弓根入路椎体成形术和椎体后凸成形术皆能有效的缓解患者疼痛症状.患者术后前壁、中心和后壁垂直高度较术前明显增加,3组患者术后伤椎后凸角显著改善（均P＜0.05）.椎体后凸成形术在前壁、中心和后壁垂直高度恢复和伤椎后凸角改善上明显.结论 对于骨质疏松性重度椎体压缩性骨折患者的治疗,椎体成形术和椎体后凸成形术皆能有效缓解疼痛症状,恢复伤椎椎体结构和椎体高度.单双侧椎体成形术效果大致,手术简单、耗时短,费用较少,但在骨水泥渗漏率和恢复椎体高度上不及椎体后凸成形术.
Objective To determine the effects of unilateral and bilateral vertebral transpedicular vertebroplasty and kyphoplasty for the treatment of severe osteoporotic vertebral compression fracture.Methods The clinical data of 63 patients with severe osteoporotic vertebral compression fracture,who underwent vertebroplasty or kyphoplasty in our hospital between January 2013 and August 2016,were retrospectively analyzed.The operative time,intraoperative fluoroscopy time,average vertebral bone cement injection volume,bone cement leakage,preoperative and postoperative visual analogue scale （VAS） scores,pain remission rate,and SF-36 health survey questionnaire were recorded.The changes of the vertebral anterior wall,center,and posterior wall vertical height and vertebral kyphosis angle were compared at the baseline,at 3d after the operation,and at the last follow-up.The patients were followed up for 1 year after the operaiton and the time of new vertebral fracture was recorded.Results For the treatment of severe osteoporotic vertebral compression fracture,unilateral transpedicular vertebroplasty was least costly on the operative time and fluoroscopy time.Its bone cement volume per section was less than that of the kyphoplasty,which was the same as the bilateral transpedicular vertebroplasty.The unilateral and bilateral transpedicular vertebroplasty showed more bone cement leakage and the new vertebral fracture time was shorter.The VAS score,physical health comprehensive score and mental health comprehensive score after the operation in the 3 groups were better than those before the operation.Both of the unilateral and bilateral transpedicular vertebroplasty could effectively relieve pain symptoms.The anterior wall,center and posterior wall vertical height significantly increased after the operation compared with those before the operation.The vertebral kyphosis angle in the 3 groups was significantly improved （all P〈0.05）.Kyphoplasty significantly favored the recovery of anterior wall,center and posterior wall vert
作者
连俊锋
严瀚
郭奇峰
邓志荣
朱建伟
Lian Junfeng;Yan Han;Guo Qifeng;Deng Zhirong;Zhu Jianwei(Department of Orthopedics,Dapu County People＇s Hospital,Meizhou,Guangdong 514299,China)
出处
《中华生物医学工程杂志》
CAS
2017年第4期291-296,共6页
Chinese Journal of Biomedical Engineering
关键词
椎体成形术
骨质疏松
压缩性骨折
Vertebroplasty
Osteoporosis
Compressive fractures
