摘要
目的比较球囊扩张经皮椎体后凸成形术(PKP)与Sky骨扩张器PKP的临床应用结果及优缺点。方法2004年10月至2006年2月分别应用球囊骨扩张器(球囊组)与Sky骨扩张器(Sky组),对49例患者86个椎体行PKP,其中Sky组24例29个椎体,球囊组25例57个椎体。记录手术时间、术中出血量、骨水泥注射量,观察患者手术前后疼痛和功能改善情况,观察骨水泥在椎体内的分布以及病椎的高度改变。结果所有患者均安全完成手术。以平均每个椎体计算,两组手术时间、出血量、器械材料费用相比较,差异均无统计学意义(P>0.05)。球囊组平均每侧注入PMMA骨水泥的量较Sky组多(P<0.05)。两组患者术后VAS和ODI评分均较术前减少(P<0.05)。X线片观察球囊组单侧穿刺的32个椎体有24个见骨水泥越过中线到达椎体对侧;Sky组单侧穿刺的28个椎体见骨水泥主要局限在穿刺侧,有6个椎体见少量骨水泥越过中线到达椎体对侧。两组病椎高度均有不同程度的恢复,球囊组椎体前缘和中线高度恢复较明显,Sky组以椎体中线高度恢复较明显。球囊组有4例5个椎体出现椎间隙少量渗漏。Sky组中出现椎间隙骨水泥少量渗漏5例7个椎体,椎体后缘渗漏3例3个椎体,椎旁少量渗漏1例1个椎体。Sky骨扩张器5例退出困难,1例断裂。1例球囊在扩张第3个椎体时破裂。结论球囊扩张PKP与Sky骨扩张器PKP治疗疼痛性压缩骨折均有良好的临床疗效;Sky骨扩张器PKP在单节段椎体中选用较好,球囊扩张PKP对多节段椎体骨折更为适用。
Objective To compare the clinical results of balloon percutaneous kyphoplasty （PKP） and ＂Sky-bone expander＂ PKP. Methods From October 2004 to February 2006, 25 cases（57 vertebrae） balloon PKP and 24 cases （ 29 vertebrae） ＂ Sky-bone expander＂ PKP procedures were performed. The operation time, bleeding volume, cement injected volume were recorded during operation. The patients＇ pain relief and functional activities recovery were evaluated after operation. The distribution of the cement and the restoration of vertebral height were also observed post-operation. All these patients were followed-up by telephone or clinic consults after discharged. Results All cases were successfully experienced procedures. There are no significant differences in operative time, bleeding volume and cost of every vertebrae in these two group（P 〉 0.05 ）. The balloon group had larger cement injected volume per pedicle than Sky group （4. 27± 1.08） ml vs. （3. 15 ±0. 78） ml （P 〈0.05）. The VAS and ODI scoring of these two groups were both decreased significantly after operation. The vertebral height were restored in both two groups with anterior height and midline height restored significantly in balloon group and midline height restored significantly in Sky group. The cement distribution of ＂ Sky-bone expander＂ PKP with unipediclar injection mostly limited in the injective side of the vertebral body, but most of the balloon PKP vertebrae with unipediclar injection can be seen a cross-midline cement distribution in the anterior-posterior position X ray film. Conclusions Both balloon PKP and ＂ Sky-bone expander＂ PKP are efficacious and safety in the treatment of vertebral compression fractures. ＂ Sky-bone expander＂ PKP is more suitable for single level compressive fracture while balloon PKP is especially suitable for multiple level compressive fractures.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2006年第24期1667-1671,共5页
Chinese Journal of Surgery
关键词
脊柱后凸
脊柱骨折
骨质疏松
胸椎
腰椎
Kyphosis
Spinal fractures
Osteoporosis
Thoracic vertebrae
Lumbarvertebrae
