摘要
目的比较单侧与双侧人路经皮椎体成形术（PVP）治疗骨质疏松性压缩性骨折的疗效。方法回顾性分析完成椎体成形术75例患者，均为单一骨质疏松性压缩骨折的椎体，其中35例为单侧椎弓根人路，40例双侧椎弓根入路。术前及术后进行视觉模拟疼痛评分及自理生活能力评估。结果两组椎体压缩性骨折椎体采用经皮椎体成形术均获成功，影像学并发症包括骨水泥漏入椎间盘、周围软组织、椎体周围静脉引流，但上述患者均无明显的临床症状，两组疼痛缓解和功能改善均显著（P〈0．01）；两组间术后24h及随访期末（1～3个月）视觉模拟疼痛评分和自理生活能力评分比较差异无统计学意义（P〉0．05）；双侧组出现并发症31例（77．5％），单侧组出现并发症10例（28．6％），两组比较差异有统计学意义（P〈0．01）；双侧组手术平均时间60min，单侧组手术平均时间35min，两组比较差异有统计学意义（P〈0．01）。结论单侧入路PVP对于治疗骨质疏松性椎体严重压缩性骨折是可行和有效的，可以获得较好的疼痛缓解和功能恢复的效果，临床并发症较少，缩短手术时间，值得临床上推广应用。
Objective To compare the curative effectiveness of PVP by trans-single-pedicle approach or trans-both-pedicles approach for osteoporotic vertebral compression fractures. Methods Seventy - five patients with osteoporotic vertebral compression fractures were retrospectively reviewed. The vertebral column all were osteoporotic vertebral compression fractures,include 35 cases of trans-single-pedicle and 40 cases of trans-both-pedicles. The VAS （ Visual Analog Scale） and ADL （ Activity of Daily Living） of pre - operation and post - operation were recorded and analyzed. Results All the procedures were successful between adjacent disc, para- vertebral soft tissues, prevertebral venous plexus without any clinical the two groups. The cement leakage observed on radiographs included slight leakage into the symptoms. Pain relief and activity improvement were remarkable after PVP between the two groups （P 〈 0.01 ）. The VAS and ADL were not significant at 24 h and 1 - 3 months follow - up after PVP （ P 〉 0.05 ）, but the complication of trans-single-pedicle approach group was significantly smaller and the operation time of trans-single-pedicle approach group was significantly shorter than the other group. Conclusion Treatment of osteoporotic vertebral compression fractures with vertebroplasty by trans-single-pedicle approach is safe and effective, gets better pain relief and functional recovery of the effect of clinical complications, shortens the operation time, it is worth the clinical application.
出处
《临床外科杂志》
2010年第6期407-409,共3页
Journal of Clinical Surgery
关键词
椎体
单侧椎弓根入路
骨质疏松性椎体压缩性骨折
vertebral column
trans-single-pedicle approach
osteoporotic vertebral compression fractures
