CAJ | 학술논문

目的：探讨新型G型臂X线机下行双侧经皮椎体后凸成形术（ percutaneous kyphoplasty，PKP）对骨质疏松性椎体压缩骨折的疗效。方法回顾性分析行PKP治疗的骨质疏松性椎体压缩骨折患者118例（193个椎体）的临床数据，按普通C型臂X线机下经单侧椎弓根途径行PKP和新型G型臂X线机下经双侧椎弓根途径行PKP分为2组。普通X线机组68例121个椎体，新型X线机组50例72个椎体，比较2组患者手术时间、骨水泥注入量、手术前后疼痛视觉模拟评分（ visual analogue scale，VAS）、椎体平均高度、局部Cobb角改善及常见并发症的发生情况。结果普通X线机组1例患者因不能耐受，终止手术，余117例患者顺利完成手术。普通X线机组手术时间（55±12）min，新型X线机组手术时间（53±14）min，2组间比较差异无统计学意义（ P﹥0.05）；2组术后1年时VAS较治疗前明显改善（ P﹤0.05），组间比较差异无统计学意义（ P﹥0.05）；2组手术后椎体平均高度及局部Cobb角改变较治疗前明显改善（ P﹤0.05），组间比较差异有统计学意义（ P﹤0.05）；普通X线机组椎体再骨折发生率为23.5％，新型X线机组为6.0％，2组比较差异有统计学意义（ P﹤0.05）。结论新型G型臂X线机下行双侧PKP和普通X线机下行单侧PKP对骨质疏松性椎体压缩骨折临床效果同样满意，单侧穿刺时间优势不再明显，而前者具有椎体平均高度恢复及局部Cobb角改变良、椎体再骨折的发生率低及X线暴露量少等优点。
목적：탐토신형G형비X선궤하행쌍측경피추체후철성형술（ percutaneous kyphoplasty，PKP）대골질소송성추체압축골절적료효。방법회고성분석행PKP치료적골질소송성추체압축골절환자118례（193개추체）적림상수거，안보통C형비X선궤하경단측추궁근도경행PKP화신형G형비X선궤하경쌍측추궁근도경행PKP분위2조。보통X선궤조68례121개추체，신형X선궤조50례72개추체，비교2조환자수술시간、골수니주입량、수술전후동통시각모의평분（ visual analogue scale，VAS）、추체평균고도、국부Cobb각개선급상견병발증적발생정황。결과보통X선궤조1례환자인불능내수，종지수술，여117례환자순리완성수술。보통X선궤조수술시간（55±12）min，신형X선궤조수술시간（53±14）min，2조간비교차이무통계학의의（ P﹥0.05）；2조술후1년시VAS교치료전명현개선（ P﹤0.05），조간비교차이무통계학의의（ P﹥0.05）；2조수술후추체평균고도급국부Cobb각개변교치료전명현개선（ P﹤0.05），조간비교차이유통계학의의（ P﹤0.05）；보통X선궤조추체재골절발생솔위23.5％，신형X선궤조위6.0％，2조비교차이유통계학의의（ P﹤0.05）。결론신형G형비X선궤하행쌍측PKP화보통X선궤하행단측PKP대골질소송성추체압축골절림상효과동양만의，단측천자시간우세불재명현，이전자구유추체평균고도회복급국부Cobb각개변량、추체재골절적발생솔저급X선폭로량소등우점。
Objective To Explore the clinical outcomes of bilateral kyphoplasty forosteoporotic compression fracture with the new G-arm X-ray machine. Methods 118 cases(193 vertebrae)who sustained osteoporotic vertebral compression fracture and underwent percutaneous kyphoplasty were reviewed retrospectively. All cases were divided into two groups according to unilateral with common C-arm X-ray machine or bilateral with the new G-arm X-ray machine approach. The common group( 68 patients,121 vertebrae)while the new X-ray group(50 patients,72 vertebrae ). The operation time,the amount of bone cement and the visual analogue scale( VAS),vertebral body height,Cobb angle at pre and post-operation and incidence of complications were used to observe the difference between two groups. Results All but one patient underwent surgery successfully. The common group had an average operative time of(55 ± 12)min while the new X-ray group(53 ± 14)min. There was no significant difference in the operation time between two groups( P﹥0 . 05 ). The VAS score decreased significantly after operation ( P﹤0 . 05 ),but no significant difference was noted between two groups( P ﹥0 . 05 ),while the rate of adjacent vertebral fractures had significant difference( P ﹤ 0 . 05 ). Conclusion Both unilateral or bilateral kyphoplasty are reliable for osteoporotic vertebral compression fractures,but the bilateral kyphoplasty has the advantage of better recovery for average vertebral height and local Cobb angle and lower adjacent vertebral fractures rate.