摘要
目的比较单侧与双侧椎体成形术治疗老年骨质疏松椎体压缩性骨折(OVCF)的短期疗效。方法将揭阳市人民医院2017年1月至2018年6月收治的88例OVCF患者按照随机数表法随机分为单侧组及双侧组,单侧组43例,双侧组45例,比较两组患者手术时间、X线曝光次数、骨水泥注射量及术后骨水泥渗透率,观察手术前后视觉模拟量表(VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)、椎体高度及Cobb角的变化。结果单侧组手术时间、X线曝光次数及骨水泥注射量少于双侧组(P<0.05)。两组患者术后VAS评分、ODI、椎体高度及Cobb角均较术前改善(P<0.05),但两组术后各指标及骨水泥渗透率比较,差异无统计学意义(P>0.05)。两组患者术中均无神经损伤,术后无肺部栓塞、邻近椎体再骨折并发症发生。结论穿刺终点超过椎体中线时,单侧椎体成形术可获得与双侧手术相当的短期疗效;与双侧手术相比,单侧椎体成形术可缩短手术时间,减少X线辐射和骨水泥注射量,提高临床治疗的成本-效果比。
Objective To compare short-term efficacy between unipedicular and bipedicular vertebroplasty in the treatment of elderly patients with osteoporotic vertebral compression fracture(OVCF).Methods A total of 88 elderly patients with OVCF treated from January 2017 to June 2018 in Jieyang People's Hospital were divided randomly into two groups by random digital table method,unipedicular group by unipedicular approach(43 cases),and bipedicular group by bipedicular approach(45 cases).Operation time,X-ray exposure times,bone cement volume and postoperative bone cement leakage rate were compared between two groups,changes of visual analogue scale(VAS)score,Oswestry disability index(ODI),vertebral height and Cobb's angle were observed before and after the surgery.Results Operation time,X-ray exposure times and bone cement volume in unipedicular group were smaller than those in bipedicular group(P<0.05).Postoperative VAS score,ODI,vertebral height and Cobb's angle all improved when compared with preoperative ones(P<0.05),while postoperative parameters as well as bone cement leakage rate between two groups were similar(P>0.05).During the operation,no nerve injury was found,also,there had no postoperative complications of pulmonary embolism or vertebral refracture at the adjacent segment.Conclusions With the puncture endpoint bypass the vertebral midline,unipedicular and bipedicular vertebroplasty for treatment of elderly patients with OVCF could achieve similar short-term efficacy.Compared with bipedicular procedure,unipedicular approach can increase cost-effectiveness ratio of treatment with shorter operation time as well as less X-ray radiation and bone cement injection volume.
作者
何旭辉
郑潮顺
胡铮
郭跃跃
HE Xuhui;ZHENG Chaoshun;HU Zheng;GUO Yueyue(Department of Orthopedics II,Jieyang People's Hospital,Jieyang,Guangdong 522000,China)
出处
《中国骨科临床与基础研究杂志》
2019年第4期223-228,共6页
Chinese Orthopaedic Journal of Clinical and Basic Research
关键词
骨质疏松
脊柱骨折
椎体成形术
骨黏合剂
单侧手术
双侧手术
老年人
Osteoporosis
Spinal fractures
Vertebroplasty
Bone cements
Unilateral procedure
Bilateral procedure
Aged
