CAJ | 학술논문

目的比较单侧与双侧经椎弓根入路经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折的临床疗效.方法回顾性分析2009年1月至2012年1月采用PVP治疗且随访时间≥1年的101例单节段骨质疏松性椎体压缩骨折患者资料,按手术入路不同分为2组:单侧组45例,男11例,女34例;平均年龄为(69.4±10.4)岁;采用单侧经椎弓根入路PVP治疗.双侧组56例,男6例,女50例;平均年龄为(69.7±9.7)岁;采用双侧经椎弓根入路PVP治疗.比较两组患者的手术时间、骨水泥注入量、骨水泥渗漏率、骨折椎体高度恢复程度、后凸cobb角矫正度数及疼痛视觉模拟评分(VAS)等. 结果单侧组患者手术时间[(36.4±6.0) min]较双侧组[(52.9 ±6.8) min]短,骨水泥注入量[(3.72±1.09) mL]较双侧组[(4.29±1.12) mL]少,差异均有统计学意义(P＜0.05).两组患者术后椎体前缘压缩改善程度、椎体中央压缩改善程度及后凸cobb角矫正度数比较差异均无统计学意义(P＞0.05).两组患者术后24 h、3个月及12个月VAS评分均明显低于术前,差异有统计学意义(P＜0.05),但两组患者之间术后24 h、3个月及12个月VAS评分比较差异均无统计学意义(P＞0.05).虽然单侧组患者骨水泥渗漏率[28.9％ (13/45)]较双侧组[46.4％ (26/56)]低,但二者比较差异无统计学意义(P＞0.05). 结论单侧与双侧经椎弓根入路PVP治疗骨质疏松性椎体压缩骨折均可取得满意的止痛效果,且前者具有创伤小、手术时间短等优点.
목적 비교단측여쌍측경추궁근입로경피추체성형술(PVP)치료골질소송성추체압축골절적림상료효.방법 회고성분석2009년1월지2012년1월채용PVP치료차수방시간≥1년적101례단절단골질소송성추체압축골절환자자료,안수술입로불동분위2조:단측조45례,남11례,녀34례;평균년령위(69.4±10.4)세;채용단측경추궁근입로PVP치료.쌍측조56례,남6례,녀50례;평균년령위(69.7±9.7)세;채용쌍측경추궁근입로PVP치료.비교량조환자적수술시간、골수니주입량、골수니삼루솔、골절추체고도회복정도、후철cobb각교정도수급동통시각모의평분(VAS)등. 결과 단측조환자수술시간[(36.4±6.0) min]교쌍측조[(52.9 ±6.8) min]단,골수니주입량[(3.72±1.09) mL]교쌍측조[(4.29±1.12) mL]소,차이균유통계학의의(P＜0.05).량조환자술후추체전연압축개선정도、추체중앙압축개선정도급후철cobb각교정도수비교차이균무통계학의의(P＞0.05).량조환자술후24 h、3개월급12개월VAS평분균명현저우술전,차이유통계학의의(P＜0.05),단량조환자지간술후24 h、3개월급12개월VAS평분비교차이균무통계학의의(P＞0.05).수연단측조환자골수니삼루솔[28.9％ (13/45)]교쌍측조[46.4％ (26/56)]저,단이자비교차이무통계학의의(P＞0.05). 결론 단측여쌍측경추궁근입로PVP치료골질소송성추체압축골절균가취득만의적지통효과,차전자구유창상소、수술시간단등우점.
Objective To compare the clinical efficacy and safety of unipedicular versus bipedicular percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures.Methods Enrolled for this study were 101 patients with osteoporotic vertebral compression fracture who had been treated by PVP in our department from January 2009 to January 2012 and followed up for at least one year.They were divided into 2 groups according to the approaches they used.In the unilateral group,there were 45 patients,11 males and 34 women,with a mean age of 69.4 ± 10.4 years; in the bilateral group,there were 56 patients,6 males and 50 women,with a mean age of 69.7 ± 9.7 years.The 2 groups were compared in terms of operation time,bone cement volume injected,cement leakage,vertebral height restoration,kyphosis correction and visual analogue scale (VAS) score.Results The unipedicular group incurred significantly shorter operation time (36.4±6.0 min) and significantly less bone cement volume injected (3.72 ± 1.09 mL) than the bipedicular group (52.9 ± 6.8 min and 4.29 ± 1.12 mL respectively) (P ＜ 0.05).There were no significant differences between the 2 groups in anterior vertebral height restoration,middle vertebral height restoration or kyphosis correction (P ＞ 0.05).The VAS scores at 24 hours,3 and 12 months postoperation were significantly lower than preoperation in both groups (P ＜ 0.05),but there were no such significant differences between the 2 groups (P ＞ 0.05).The cement leakage rate for the unipedicular group [28.9％ (13/45)]was insignificantly lower than that for the bipedicular group [46.4％ (26/56)] (P ＞ 0.05).Conclusions Both unipedicular and bipedicular PVP can obtain satisfactory analgesia for the treatment of osteoporotic vertebral compression fractures but the former may have advantages of less invasion and shorter operation time.