弯角椎体成形术治疗胸腰椎骨质疏松性椎体压缩骨折的疗效分析

Effect of percutaneous curved vertebroplasty in the treatment of osteoporotic thoracolumbar vertebral compressive fractures

中文关键词:  胸腰椎压缩性骨折  弯角椎体成形术  骨质疏松  微创

英文关键词:Thoracolumbar vertebral fractures  Percutaneous curved vertebroplasty  Osteoporosis  Minimal invasive

中文摘要:

  【摘要】 目的：评估分析弯角椎体成形术（percutaneous curved vertebroplasty，PCVP）治疗胸腰椎骨质疏松性椎体压缩骨折的临床疗效。方法：选取96例胸腰椎骨质疏松性椎体压缩骨折患者，共128节病椎，将其分为弯角组（36例，43节）、单侧组（32例，42节）及双侧组（28例，43节），分别行PCVP及单侧、双侧椎弓根入路椎体成形术。3组患者的性别、年龄、骨密度及病椎节段分布均无统计学差异（P>0.05）。统计3组手术时间、X线曝光次数、骨水泥注入量及术前、术后24h、术后3个月疼痛视觉模拟评分（VAS评分），术后复查CT评价骨水泥渗漏率，进行统计学分析。结果：弯角组与单侧组的手术时间、X线曝光次数均明显少于双侧组，差异有统计学意义（P<0.05），弯角组和单侧组无显著性差异（P>0.05）。弯角组、单侧组、双侧组的骨水泥注入量比较，双侧组最多（6.2±1.5ml），弯角组次之（4.5±1.3ml），单侧组最少（3.4±1.2ml），组间两两比较差异有统计学意义（P<0.05）。弯角组、单侧组、双侧组的骨水泥渗漏率比较，单侧组（28.6%，12/42）最高，双侧组（18.6%，8/43）次之，弯角组（9.3%，4/43）最低，组间两两比较差异有统计学意义（P<0.05）。3组患者术后疼痛均明显缓解，术后24h及术后3个月VAS评分均明显低于术前（P<0.05），术后24h及术后3个月VAS评分比较无显著性差异（P>0.05），同时间点组间比较亦无显著性差异（P>0.05）。结论：PCVP具有操作简单、手术时间短、X线透视次数少、创伤小、并发症少等优势，是治疗胸腰椎骨质疏松性椎体压缩骨折的有效微创手术方法。

英文摘要:

  【Abstract】 Objectives: To investigate the clinical value of percutaneous curved vertebroplasty(PCVP) in the treatment of osteoporotic thoracolumbar vertebral compressive fractures. Methods: 96 patients(128 vertebrae) suffering from osteoporotic thoracolumbar vertebral compressive fractures were divided into three groups: curved group(36 patients, 43 vertebrae), unilateral group(32 patients, 42 vertebrae) and bilateral group(28 patients, 43 vertebrae). There was no significant difference among the three groups in gender, age, bone mineral density and diseased vertebral segment(P>0.05). The average operation time, X-ray exposure, bone cement injection volume, bone cement leakage rate were recored and compared. The VAS scores were compared at preoperation, 24 hours and 3 months after operation. Results: The operation time of curved group and unilateral group were less than that of bilateral group, the differences were statistically significant(P<0.05). But there was no statistical difference between curved group and unilateral group(P>0.05). The X-ray exposure of curved group and unilateral group were less than that of bilateral group, the differences were statistically significant(P<0.05). But there was no statistical difference between curved group and unilateral group(P>0.05). As for the bone cement injection volume, bilateral group(6.2±1.5ml) had the highest volume and following was curved group(4.5±1.3ml), and the least was unilateral group(3.4±1.2ml), the differences were statistically significant among the three groups(P<0.05). As for the bone cement leakage rate, unilateral group(28.6%, 12/42) was the most and following was bilateral group(18.6%, 8/43), and the least was curved group(9.3%, 4/43), the differences were statistically significant among the three groups(P<0.05). All the patients in the three groups obtained obvious pain relief. The average VAS score at 24 hours and 3 months after operation was lower than that at preoperation(P<0.05). But there was no statistical difference in the average VAS score between 24 hours and 3 months after operation(P>0.05), and there were no statistical differences among the three groups(P>0.05). Conclusions: Percutaneous curved vertebroplasty has the advantage of easy operation, shorter operation time, less X-ray exposure, less trauma and complications, which is a minimal invasive method for osteoporotic thoracolumbar vertebral fractures.