摘要
目的探讨经皮椎体成形(PVP)术中应用单侧穿刺囊袋扩张技术治疗椎体四壁不完整骨质疏松性椎体压缩骨折的疗效及安全性。方法回顾性分析自2016-10—2017-09行PVP治疗椎体四壁不完整骨质疏松性椎体压缩骨折,所有患者术中均采用单侧椎弓根外穿刺囊袋扩张技术。术后采用VAS评分评估疼痛缓解程度,采用改良Stauffer-Coventry评分系统评估临床症状缓解情况。记录手术前后侧位X线片上伤椎椎体高度及后凸Cobb角。结果术后横断面CT显示伤椎骨水泥均由中央向四周弥散,分布良好,各个方向均无渗漏。21例均获得随访,随访时间平均12.7(7～19)个月。末次随访时疼痛VAS评分由术前(8.1±0.8)分降至(2.0±0.7)分,伤椎椎体高度由术前(13.4±1.2)mm增加为(22.5±1.2)mm,后凸Cobb角由术前(27.9±2.2)°改善为(12.2±1.0)°,差异有统计学意义(P <0.05)。末次随访时改良Stauffer-Coventry评分:优13例,良6例,可2例。结论 PVP术中应用单侧穿刺囊袋扩张技术治疗椎体四壁不完整骨质疏松性椎体压缩骨折临床疗效满意,椎体高度恢复理想,可有效降低骨水泥渗漏风险。
Objective To explore the safety and curative effect of percutaneous vertebroplasty (PVP) with bone filling mesh container for osteoporotic vertebral comj)ression fractures (OVCFs) associiited with peripheral wall damage via unilateral extrapedicle of vertebral arch approach. Methods Twenty-one patients suffered from OVCFs with peripheral wiill damage from October 2016 lo September 2017 were treated by PVP with bone filling mesh container via unilateral extra -pedicle of vertebral arch approach. The VAS score for extent of pain, the Stauffer -Coventry7 score for relief of clinical symptoms, the height of affected vertebra and the Cobb angle measured on X-ray films were obtained for evaluation of the results. Results The postoperative CT cross-sectional images showed tlud bone cement in fractured vertebra spreaded well l)v the center and no cement leakage were found in all directions. All patients were followed lip for 7-19 months (mean. 12.7 months). At latest follow up. VAS score reduced from pro-operative (8.1 ±0.8) to (2.0 ±0.7), the height of affected vertebra increased from prt*oprrative (13.4±1.2) mm to (22.5±1.2) min and the kyphotic angle was improved from pie-operative (27.9±2.2)° to (12.2± 1.0)°, the differences were statistically significant (P <0.05). According to the Stauffer-Coventry score, operative effect was classified as excellent in 13 patients, good in 6, and fair in 2. Conclusion PVP with bone filling mesh container via unilateral extra-pedide of vertebral arch approach is a safe and efficacious procedure to treat OVCFs with peripheral wall damage, which could restore the vertebral height well and irduce the risk ol cement leakage significantly.
作者
王栋
李益明
刘光旺
冯杰
张建伟
周恒才
戴维享
马超
WANG Dong;LI Yi-ming;LIU Guang-wang;FENG Jie;ZHANG Jian-wei;ZHOU Heng-cai;DAI Wei-xiang;MA Chao(Department of Spine Surgery ,Xiizhou Central Hospital,Xiizhou,Jiangsu 221000,China)
出处
《中国骨与关节损伤杂志》
2019年第3期244-246,共3页
Chinese Journal of Bone and Joint Injury
基金
江苏省社会发展-重点病种规范化诊疗项目(BE2016640)
关键词
骨质疏松性椎体压缩骨折
椎体四壁不完整
经皮椎体成形术
囊袋扩张技术
单侧穿刺
Osteoporotic vertebral coinprrssion fractures
Peripheral wall damage
Percutaneous vertebroplasty
Bone filling mesh eontiiiner
Unilatend extra-pedicle of vertebral arch approach
