[1]赵胜军,赵丽,金宝城,等.单侧与双侧经皮椎体后凸成形术治疗老年新鲜骨质疏松性椎体骨折的临床疗效[J].中华老年骨科与康复电子杂志,2017,(03):150-156.[doi:DOI：10.3877/cma.j.issn.2096-0263.2017.03.004]
　Zhao Shengjun,Zhao Li,Jin Baocheng,et al.Effectiveness of unilateral and bilateral percutaneous kyphoplasty for fresh senile osteoporotic vertebral compression fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2017,(03):150-156.[doi:DOI：10.3877/cma.j.issn.2096-0263.2017.03.004]
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单侧与双侧经皮椎体后凸成形术治疗老年新鲜骨质疏松性椎体骨折的临床疗效()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2017年03期
页码:
150-156
栏目:
论著
出版日期:
2017-06-01

文章信息/Info

Title:
Effectiveness of unilateral and bilateral percutaneous kyphoplasty for fresh senile osteoporotic vertebral compression fractures
作者:
赵胜军 1; 赵丽 2; 金宝城 1; 王青松 1; 孙彦豹 1; 徐文硕 1
067000 承德市中心医院骨二科 1；承德医学院附属医院超声科 2
Author(s):
Zhao Shengjun1;  Zhao Li2;  Jin Baocheng1; Wang Qingsong1;  Sun Yanbao1;  Xu Wenshuo1
1Second department of Orthopedics, the Central Hospital of Chengde, Chengde 067000, China; 2Department of Ultrasound, Affiliated Hospital of Chengde Medical College, Chengde 067000, China
关键词:
椎体成形术;  骨质疏松性骨折;  骨质疏松症;  老年人
Keywords:
Vertebroplasty;  Osteoporotic fractures;  Osteoporosis;  Aged
DOI:
DOI：10.3877/cma.j.issn.2096-0263.2017.03.004
文献标志码:
A
摘要:
目的 探讨单侧与双侧经皮椎体后凸成形术（PKP）治疗老年新鲜骨质疏松性椎体压缩骨折（OVCF）的临床疗效。方法 回顾性分析 2009年 1月至 2015年 10月间，承德市中心医院收治的行 PKP 治疗的 148 例老年新鲜胸腰段 OVCF 患者，其中单侧穿刺组 76 例（椎体），双侧穿刺组 72 例（椎体）。对比分析两组患者的手术时间、穿刺次数、放射线暴露次数、骨水泥渗漏例数、术前及术后疼痛视觉模拟评分（VAS）、椎体后凸 Cobb角改善情况，评估手术疗效。结果 148例患者均成功穿刺并顺利完成手术。与双侧穿刺相比，单侧手术组患者的手术时间较短（[ 45.6±2.0）min vs （29.4±1.8）min]；穿刺次数较少（[ 7.9±1.8）次 vs （3.6±1.2）次]；放射线暴露次数较少（[ 12.5±1.6）次 vs （7.2±1.3）次）；骨水泥渗漏率较低（13.89% vs 6.58%）；差异均有统计学意义（t=18.937，t=14.219，t=12.786，t=4.051，P＜0.001）。两组 VAS 评分术后较术前均有改善，差异均有统计学意义（单侧组：F=25.381；双侧组：F=23.720，均 P＜0.001），组间比较除术后 1 d 单侧穿刺组（[ 4.17±0.26）分]低于双侧穿刺组（[ 4.29±0.31）分]外（F=8.451，P＜0.05），其余时间点差异均无统计学意义。单侧穿刺组与双侧穿刺组骨水泥注入量为（2.8±0.3）ml和（3.1±0.5）ml，差异无统计学意义。单侧与双侧穿刺组术后椎体后凸 Cobb角较术前均有改善（F=12.981，F=17.660，P＜0.001），各时间点组间比较差异无统计学意义。两组患者均无脊髓、神经损伤，无切口感染、出血、肺栓塞等并发症。结论 单侧穿刺 PKP可以显著缩短手术时间，减少穿刺风险，降低医患的放射线暴露及骨水泥渗漏率，临床效果良好。
Abstract:
Objective To explore the effectiveness of unilateral and bilateral percutaneous kyphoplasty in the treatment of fresh senile osteoporotic vertebral compression fractures. Methods One hundred and forty eight elderly patients with fresh thoracolumbar vertebral osteoporotic compression fractures treated in Central Hospital of Chengde from January 2009 to October 2015 were retrospectively analyzed, they were divided into the unilateral puncture group (76 vertebras) and the bilateral puncture group (72 vertebras). Operation time, puncture times, radiation exposure, cement extravasation, preoperative and postoperative visual analogue scale (VAS) score, postoperative Cobb angle improvement were compared between two groups to assess the surgical effectiveness. Results One hundred and forty eight patients were treated successfully. The operation time of unilateral group was shorter than the bilateral group (29.4 ± 1.8 min vs 45.6±2.0 min) ; puncture times of unilateral group was less than bilateral group (3.6±1.2 times vs 7.9± 1.8 times)；same as the radiation exposure (7.2 ± 1.3 times vs 12.5 ± 1.6 times) and incidence of cement extravasation (6.58% vs 13.89% ), all differences were statistically significant (t=18.937, t=14.219, t= 12.786, t=4.051, P<0.001). The VAS score of two groups were significantly improved after treatment (unilateral: F=25.381, bilateral: F=23.720, P<0.001), except for postoperative 1 d of unilateral group (4.17±0.26 points) was lower than bilateral group (4.29±0.31 points) (F=8.451, P<0.001), there were no significant differences between two groups. Volume of cement injection of two groups were (2.8±0.3) ml and (3.1±0.5) ml, no statistically significant differences were observed. The Cobb angle of each group were improved after treatment (F=12.981, F=17.660, P＜0.001), while no statistically significant difference was observed at different time points in intragroup. There were no spinal cord or nerve damage, incision infection and other complications (bleeding, pulmonary embolism) in both groups. Conclusion Unilateral puncture PKP treat OVCFs can achieve satisfactory effectiveness, significantly shorter operation time, less puncture risk, radiation exposure and cement extravasation.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：承德市科技支撑项目（201601A048）
更新日期/Last Update: 2017-06-01