CAJ | 학술논문

背景:研究证明经皮椎体成形是修复骨质疏松性椎体压缩骨折一种比较好的方法,但是具体的椎弓根入路方案研究尚少,采用单侧还是双侧经椎弓根入路经皮椎体成形来修复骨质疏松性椎体压缩骨折目前尚有争议.目的:比较单侧及双侧经椎弓根入路经皮椎体成形对骨质疏松性胸腰椎体压缩骨折的修复效果.方法:选择新疆喀什地区第一人民医院骨科2010年6月到2013年6月收治的118例随访时间大于1年的骨质疏松性胸腰椎体压缩骨折患者,根据随机数字表法分为两组,分别采取单侧和双侧经椎弓根入路经皮椎体成形方案治疗,每组59例.比较两组患者骨水泥注入量、骨水泥渗漏率、后凸侧凸Cobb角矫正度数、椎体平均高度变化、目测类比评分、Oswestry功能障碍指数、日常生活能力评分、健康调查简表SF-36评分及治疗后并发症发生情况.结果与结论:单侧组骨水泥渗漏率(34%)比双侧组(37%)低,但差异无显著性意义(P=0.701 > 0.05).两组后凸Cobb角矫正度数、侧凸Cobb角矫正度数差异均无显著性意义(P> 0.05).两组间治疗前或治疗后1年椎体平均高度变化差异无显著性意义(P > 0.05),两组治疗后1年椎体平均高度均较治疗前显著改善(P< 0.05).两组间治疗前或治疗后目测类比评分、功能障碍指数问卷评分、日常生活能力评分、健康调查简表评分差异均无显著性意义(P > 0.05),两组治疗后1年目测类比疼痛评分、ODI、日常生活能力评分、SF-36评分均较治疗前显著改善(P < 0.05).单侧组骨水泥注入量比双侧组低(P=0.001 < 0.05),单侧组手术时间比双侧组短(P=0.000 < 0.05).两组均未发生严重术后并发症.提示对骨质疏松性胸腰椎体压缩骨折患者行单侧和双侧经椎弓根入路经皮椎体成形治疗均有满意的止痛和修复效果,尤其是单侧入路具有水泥注入量少、渗漏率低、手术时间短的优势. 揹景:研究證明經皮椎體成形是脩複骨質疏鬆性椎體壓縮骨摺一種比較好的方法,但是具體的椎弓根入路方案研究尚少,採用單側還是雙側經椎弓根入路經皮椎體成形來脩複骨質疏鬆性椎體壓縮骨摺目前尚有爭議.目的:比較單側及雙側經椎弓根入路經皮椎體成形對骨質疏鬆性胸腰椎體壓縮骨摺的脩複效果.方法:選擇新疆喀什地區第一人民醫院骨科2010年6月到2013年6月收治的118例隨訪時間大于1年的骨質疏鬆性胸腰椎體壓縮骨摺患者,根據隨機數字錶法分為兩組,分彆採取單側和雙側經椎弓根入路經皮椎體成形方案治療,每組59例.比較兩組患者骨水泥註入量、骨水泥滲漏率、後凸側凸Cobb角矯正度數、椎體平均高度變化、目測類比評分、Oswestry功能障礙指數、日常生活能力評分、健康調查簡錶SF-36評分及治療後併髮癥髮生情況.結果與結論:單側組骨水泥滲漏率(34%)比雙側組(37%)低,但差異無顯著性意義(P=0.701 > 0.05).兩組後凸Cobb角矯正度數、側凸Cobb角矯正度數差異均無顯著性意義(P> 0.05).兩組間治療前或治療後1年椎體平均高度變化差異無顯著性意義(P > 0.05),兩組治療後1年椎體平均高度均較治療前顯著改善(P< 0.05).兩組間治療前或治療後目測類比評分、功能障礙指數問捲評分、日常生活能力評分、健康調查簡錶評分差異均無顯著性意義(P > 0.05),兩組治療後1年目測類比疼痛評分、ODI、日常生活能力評分、SF-36評分均較治療前顯著改善(P < 0.05).單側組骨水泥註入量比雙側組低(P=0.001 < 0.05),單側組手術時間比雙側組短(P=0.000 < 0.05).兩組均未髮生嚴重術後併髮癥.提示對骨質疏鬆性胸腰椎體壓縮骨摺患者行單側和雙側經椎弓根入路經皮椎體成形治療均有滿意的止痛和脩複效果,尤其是單側入路具有水泥註入量少、滲漏率低、手術時間短的優勢.
배경:연구증명경피추체성형시수복골질소송성추체압축골절일충비교호적방법,단시구체적추궁근입로방안연구상소,채용단측환시쌍측경추궁근입로경피추체성형래수복골질소송성추체압축골절목전상유쟁의.목적:비교단측급쌍측경추궁근입로경피추체성형대골질소송성흉요추체압축골절적수복효과.방법:선택신강객십지구제일인민의원골과2010년6월도2013년6월수치적118례수방시간대우1년적골질소송성흉요추체압축골절환자,근거수궤수자표법분위량조,분별채취단측화쌍측경추궁근입로경피추체성형방안치료,매조59례.비교량조환자골수니주입량、골수니삼루솔、후철측철Cobb각교정도수、추체평균고도변화、목측류비평분、Oswestry공능장애지수、일상생활능력평분、건강조사간표SF-36평분급치료후병발증발생정황.결과여결론:단측조골수니삼루솔(34%)비쌍측조(37%)저,단차이무현저성의의(P=0.701 > 0.05).량조후철Cobb각교정도수、측철Cobb각교정도수차이균무현저성의의(P> 0.05).량조간치료전혹치료후1년추체평균고도변화차이무현저성의의(P > 0.05),량조치료후1년추체평균고도균교치료전현저개선(P< 0.05).량조간치료전혹치료후목측류비평분、공능장애지수문권평분、일상생활능력평분、건강조사간표평분차이균무현저성의의(P > 0.05),량조치료후1년목측류비동통평분、ODI、일상생활능력평분、SF-36평분균교치료전현저개선(P < 0.05).단측조골수니주입량비쌍측조저(P=0.001 < 0.05),단측조수술시간비쌍측조단(P=0.000 < 0.05).량조균미발생엄중술후병발증.제시대골질소송성흉요추체압축골절환자행단측화쌍측경추궁근입로경피추체성형치료균유만의적지통화수복효과,우기시단측입로구유수니주입량소、삼루솔저、수술시간단적우세.
BACKGROUND:Studies have shown that percutaneous vertebroplasty is a better method to repair osteoporotic vertebral compression fractures, but there are stil less specific schemes of transpedicular approach. Whether unipedicular or bipedicular approach is preferred is stil controversial. OBJECTIVE:To compare the clinical efficacy of percutaneous verterbroplastyviaunipedicular and bipedicular approach on osteoporotic vertebral compression fractures. METHODS:Totaly 118 patients with osteoporotic vertebral compression fractures who had been admitted at the Department of Orthopedics, the First People's Hospital of Kashi from June 2010 to June 2013 and folowed up over 1 year were enroled and randomly divided into unipedicular and bipedicular groups, with 59 in each group. These two groups were compared in terms of bone cement volume, bone cement leakage, kyphosis correction, vertebral height restoration, visual analog scale score, Oswestry disability index, activity of daily living scale score, SF-36 score, and postoperative complications. RESULTS AND CONCLUSION: The cement leakage rate was lower in the unipedicular group (34%) than the bipedicular group (37.3%), but there was no significant difference (P=0.701 > 0.05). The kyphosis correction and scoliosis correction had no statistical significance between the two groups (P > 0.05). The mean vertebral height was improved significantly in both two groups at 1 year after operation (P < 0.05), but there was no difference between the two groups before and after operation (P > 0.05). There were also no significant differences between the two groups in terms of visual analog scale score, Oswestry disability index, activity of daily living scale score, SF-36 score before and after operation, but these indexes were al improved significantly in each group at 1 year after operation than before operation (P < 0.05). The bone cement amount of the unipedicular group was lower than that of the bipedicular group (P=0.001 < 0.05), and the operation time was also shorter in the unipedicular group than the bipedicular group (P=0.000 < 0.05). No serious complications occurred in the two groups. These findings indicate that percutaneous verterbroplasty via unipedicular and bipedicular approach has good analgesic and repair outcomes in patients with osteoporotic vertebral compression fractures, and the unipedicular approach is better than the bipedicular approach in the folowing aspects: less bone cement volume, lower cement leakage and shorter operation time.