中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
Chinese Journal of Orthopaedic Trauma
2015年
9期
780-785
,共6页
胸椎%骨折%骨质疏松%椎体成形术%骨水泥
胸椎%骨摺%骨質疏鬆%椎體成形術%骨水泥
흉추%골절%골질소송%추체성형술%골수니
Thoracic vertebrae%Fractures,bone%Osteoporosis%Vertebroplasty%Cement
目的 通过比较单侧椎弓根旁入路与单侧椎弓根入路经皮椎体成形术(PKP)治疗下胸椎压缩性骨折的疗效,评价单侧椎弓根旁入路的可行性、安全性及有效性. 方法 回顾性分析2011年1月至2013年1月行PKP治疗下胸椎压缩性骨折的47例患者资料,根据手术方式不同分组单侧椎弓根旁入路组(A组,25例28个压缩椎体)和单侧椎弓根入路组(B组,22例24个压缩椎体).两组患者术前一般资料比较差异均无统计学意义(P＞0.05),具有可比性.比较两组患者手术时间、术中透视次数、骨水泥注入量、骨水泥渗漏发生率,术前、术后3d、术后1年的伤椎cobb角、椎体前缘高度、视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、健康调查简表(SF-36)及椎体内骨水泥的充盈程度. 结果 所有患者均顺利完成手术并随访至少1年.A组较B组手术时间较短、透视次数少、骨水泥渗漏发生率低、骨水泥充盈度好、邻近椎体骨折发生率低,差异均有统计学意义(P＜0.05).所有患者术后3d和1年的伤椎cobb角、椎体前缘高度、VAS评分、ODI、SF-36评分均较术前改善,差异均有统计学意义(P＜0.05);以上各项结果两组间比较差异均无统计学意义(P＞0.05). 结论 两种手术方式均为治疗椎体压缩骨折的有效方式,但单侧椎弓根旁入路手术时间短、透视次数少,值得进一步研究推广.
目的 通過比較單側椎弓根徬入路與單側椎弓根入路經皮椎體成形術(PKP)治療下胸椎壓縮性骨摺的療效,評價單側椎弓根徬入路的可行性、安全性及有效性. 方法 迴顧性分析2011年1月至2013年1月行PKP治療下胸椎壓縮性骨摺的47例患者資料,根據手術方式不同分組單側椎弓根徬入路組(A組,25例28箇壓縮椎體)和單側椎弓根入路組(B組,22例24箇壓縮椎體).兩組患者術前一般資料比較差異均無統計學意義(P＞0.05),具有可比性.比較兩組患者手術時間、術中透視次數、骨水泥註入量、骨水泥滲漏髮生率,術前、術後3d、術後1年的傷椎cobb角、椎體前緣高度、視覺模擬評分(VAS)、Oswestry功能障礙指數(ODI)、健康調查簡錶(SF-36)及椎體內骨水泥的充盈程度. 結果 所有患者均順利完成手術併隨訪至少1年.A組較B組手術時間較短、透視次數少、骨水泥滲漏髮生率低、骨水泥充盈度好、鄰近椎體骨摺髮生率低,差異均有統計學意義(P＜0.05).所有患者術後3d和1年的傷椎cobb角、椎體前緣高度、VAS評分、ODI、SF-36評分均較術前改善,差異均有統計學意義(P＜0.05);以上各項結果兩組間比較差異均無統計學意義(P＞0.05). 結論 兩種手術方式均為治療椎體壓縮骨摺的有效方式,但單側椎弓根徬入路手術時間短、透視次數少,值得進一步研究推廣.
목적 통과비교단측추궁근방입로여단측추궁근입로경피추체성형술(PKP)치료하흉추압축성골절적료효,평개단측추궁근방입로적가행성、안전성급유효성. 방법 회고성분석2011년1월지2013년1월행PKP치료하흉추압축성골절적47례환자자료,근거수술방식불동분조단측추궁근방입로조(A조,25례28개압축추체)화단측추궁근입로조(B조,22례24개압축추체).량조환자술전일반자료비교차이균무통계학의의(P＞0.05),구유가비성.비교량조환자수술시간、술중투시차수、골수니주입량、골수니삼루발생솔,술전、술후3d、술후1년적상추cobb각、추체전연고도、시각모의평분(VAS)、Oswestry공능장애지수(ODI)、건강조사간표(SF-36)급추체내골수니적충영정도. 결과 소유환자균순리완성수술병수방지소1년.A조교B조수술시간교단、투시차수소、골수니삼루발생솔저、골수니충영도호、린근추체골절발생솔저,차이균유통계학의의(P＜0.05).소유환자술후3d화1년적상추cobb각、추체전연고도、VAS평분、ODI、SF-36평분균교술전개선,차이균유통계학의의(P＜0.05);이상각항결과량조간비교차이균무통계학의의(P＞0.05). 결론 량충수술방식균위치료추체압축골절적유효방식,단단측추궁근방입로수술시간단、투시차수소,치득진일보연구추엄.
Objective To investigate the clinical efficacy and safety of the uni-extrapedicular percutaneous kyphoplasty (PKP) versus the unipedicular PKP in the treatment of lower osteoporotic vertebral compression fractures (OVCF).Methods From January 2011 to January 2013,47 patients with lower OVCF were treated at our department.The uni-extrapedicular PKP was conducted for 25 of them (28 compressed vertebrae,group A) while the unipedicular PKP for the other 22 (24 compressed vertebrae,group B).The 2 groups were compatible,showing no significant differences in preoperative clinical data (P ＞ 0.05).The 2 groups were compared in terms of operation time,fluoroscopy frequency,volune of injected cement,cement leakage,and cobb angle,anterior vertebral height,visual analogue scale (VAS) score,Oswestry disability index (ODI),SF-36 score,and cement filling preoperatively,3 days and one year postoperatively.Results All the patients had an uneventful operation and were followed up for at least one year.Compared with group B,group A reported significantly shorter operation time,lower fluoroscopy frequency,less cement leakage,better cement filling,and a lower rate of fracture of adjacent vertebra (all P ＜ 0.05).Compared with preoperation,all the patients obtained significant improvements in cobb angle,anterior vertebral height,VAS score,ODI,and SF-36 score after operation (all P ＜ 0.05),but there were no significant differences between the 2 groups in terms of the above items postoperatively (P ＞ 0.05).Conclusion Both of the 2 methods are safe and effective treatments of OVCF,but the uni-extrapedicular PKP may be more advantageous because it leads to shorter operation time and lower fluoroscopy frequency.
