应用弯角装置单侧穿刺行PVP治疗骨质疏松性胸腰椎压缩骨折的疗效分析

Curved injection needle for unilateral percutaneous vertebroplasty in osteoporotic vertebral compression fractures

中文关键词:  骨质疏松性胸腰椎压缩骨折  椎体成形术  弯角装置  单侧穿刺

英文关键词:Osteoporotic vertebral compression fractures  Percutaneous vertebroplasty  Curved injection needle  Unilateral

中文摘要:

  【摘要】 目的：探讨应用弯角装置单侧穿刺行经皮椎体后凸成形术（percutaneous vertebroplasty，PVP）治疗骨质疏松性胸腰椎压缩骨折（osteoporotic vertebral compression fractures，OVCFs）的临床效果。方法：回顾性分析我院2015年1月~2016年1月应用弯角装置行单侧穿刺PVP治疗的47例OVCFs患者的临床资料，男14例，女33例；年龄53~89岁（66.4±6.5岁）。36例为单节段椎体骨折，11例为双节段椎体骨折； 骨折椎体：T9 7节，T10 7节，T11 9节，T12 13节，L1 12节，L2 9节，L3 1节。记录术中透视时间、骨水泥用量，采用VAS评分、ODI评估手术前后疼痛程度及腰椎功能情况；测量计算手术前后伤椎相对高度，观察局部后凸Cobb角恢复情况；观察术中骨水泥渗漏（静脉渗漏及椎体周围渗漏）及其他并发症的发生情况。结果：术中透视时间1.6±0.3min；骨水泥用量6.7±1.2ml，骨水泥分布均匀；11例患者术中出现骨水泥渗漏，骨水泥渗漏率为23.4%。术后随访3~12个月（6.5±1.3个月），术前、术后2d和末次随访时的VAS评分、ODI、伤椎相对高度及局部后凸Cobb角分别为：7.6±1.3分、（71.4±3.2）%、0.48±0.21、15.5°±4.2°；2.2±1.0分、（27.2±2.6）%、0.82±0.17、7.2°±2.8°；1.7±0.7分、（26.5±2.7）%、0.80±0.15、7.5°±3.7°；术后2d和末次随访时的VAS评分、ODI和局部后凸Cobb角均较术前明显改善，伤椎相对高度较术前均明显恢复，差异均有统计学意义（P<0.05）；术后2d与末次随访时比较差异均无统计学意义（P>0.05）。结论：应用弯角装置行单侧穿刺PVP治疗OVCFs可使骨水泥分布均匀，安全有效，临床效果满意。

英文摘要:

  【Abstract】 Objectives: To investigate the clinical outcomes of unilateral percutaneous vertebroplasty(PVP) by using curved injection needle in osteoporotic vertebral compression fractures(OVCFs). Methods: From January 2015 to January 2016, 47 patients(14 males and 33 females) with OVCFs were enrolled in this study. The patients were 53-89 years old(66.4±6.5 years), 36 cases were single segmental vertebral fracture, 11 cases were double segment vertebral fracture. T9 fracture occured in 7 cases, T10 fracture in 7 cases, T11 fracture in 9 cases, T12 fracture in 13 cases, L1 fracture in 12 cases, L2 fracture in 9 cases, and L3 fracture in 1 case. The fluoroscopy time and bone cement dosage were recorded. The VAS score, ODI, relative height restoration of vertebra and Cobb angle were compared between preoperation and postoperation． The bone cement leakage(venous leakage and perivertebral leakage) and other complications were observed. Results: The average fluoroscopy time was 1.6±0.3min, the average bone cement dosage was 6.7±1.2ml. Bone cement leakage occured in 11 cases with the rate of 23.4%. The patients were followed up for 3-12 months(6.5±1.3 months). The VAS, ODI, the relative height of injured vertebra and the local Cobb angle before operation, at 2 days after operation and final follow-up were: 7.6±1.3, (71.4±3.2)%, 0.48±0.21, 15.5°±4.2°; 2.2±1.0, (27.2±2.6)%, 0.82±0.17, 7.2°±2.8°; 1.7±0.7, (26.5±2.7)%, 0.80±0.15, 7.5°±3.7°. At 2 days after operation and final follow-up, the VAS score, ODI score, the relative height and Cobb angle of injured vertebra were significantly improved when compared to those before operation(P<0.05); There was no significant difference between 2 days after operation and final follow-up(P>0.05). Conclusions: The advantages of unilateral PVP by using curved injection needleless in OVCFs are less fluoroscopy time, even distribution of bone cement, and less leakage.