摘要
背景:经皮椎体成形、经皮椎体后凸成形用于传统方法治疗无效的骨质疏松性椎体压缩性骨折效果良好,但在手术时机、麻醉方式、手术入路及方式等方面存在多种选择,并各有利弊。目的:观察全身麻醉下手法复位联合单侧经皮椎体成形治疗骨质疏松性椎体压缩性骨折的效果及优势。方法:2012年7月至2014年12月回顾经皮椎体成形治疗单椎体骨质疏松性椎体压缩性骨折患者53例,新方法组32例在全身麻醉下先行手法复位,再行单侧椎弓根穿刺,单侧经皮椎体成形骨水泥注射治疗;常规方法组21例采用常规的经皮椎体成形操作治疗。结果与结论:随访时间平均6个月(3-14个月)。两组患者术后3 d、术后末次随访的目测类比评分、椎体压缩率、后凸Cobb’s角均较术前显著改善,差异有显著性意义(P<0.01)。两组目测类比评分术后比较差异无显著性意义(P>0.05)。与常规方法组相比,新方法组术后椎体压缩率、后凸Cobb’s角及骨水泥渗漏率明显降低(P<0.01)。结果证实,新方法综合了经皮椎体成形与经皮椎体后凸成形的优势、单侧与双侧穿刺的优势,穿刺过程更安全,矫正后凸畸形、恢复椎体高度及生理曲度更好,同时骨水泥渗漏的危险性减少,骨水泥的形态分布更理想。
BACKGROUND：Percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture have obtained good outcomes, because the traditional method is invalid, but there are a variety of choices in operation time, anesthesia, surgical approach and method, and each method has its advantages and disadvantages. OBJECTIVE：To investigate the effect and preponderance of the manual reduction combined with unilateral percutaneous vertebroplasty under general anesthesia in the treatment of osteoporotic vertebral compression fractures. METHODS：A total of 53 patients with single vertebral osteoporotic vertebral compression fractures, who were treated with percutaneous vertebroplasty, were retrospectively analyzed from July 2012 to December 2014. The new method group （32 cases） received manual reduction, underwent unilateral pedicle puncture and bonenbsp;cement injection during unilateral percutaneous vertebroplasty under general anesthesia. The conventional method group （21 cases） received conventional percutaneous vertebroplasty. RESULTS AND CONCLUSION： There was an average of 6-month folow-up （3-14 months）. Significant differences in visual analogue scale scores, vertebral compression ratio and kyphosis Cobb’s angle were detected in the new method and the conventional method groups at 3 days post surgery and during final folow-up compared with before surgery （P 〈 0.01）. No significant difference in visual analogue scale scores was found between the two groups （P 〉 0.05）. Compared with the conventional method group, postoperative vertebral compression ratio, kyphosis Cobb’s angle and bone cement leakage rate were significantly lower in the new method group （P 〈 0.01）. Results verified that the new method combined with the advantages of percutaneous vertebroplasty and percutaneous kyphoplasty, the advantages of unilateral and bilateral puncture approach. The new method can correct kyphosis deformity, effectively recover the vertebral height and physiological curvature and the puncture is safe. Simultaneously, the leakage rate of bone cement is reduced, and the distribution of bone cement is ideal.
出处
《中国组织工程研究》
CAS
北大核心
2015年第31期4960-4966,共7页
Chinese Journal of Tissue Engineering Research
基金
南昌市科技支撑计划项目-社会发展技术领域(2014)(2014-SFJS-SWYY-002)~~
作者简介
吴鸿，男，1969年生，汉族，江西省南昌市人，2012年中南大学湘雅医院毕业，医学博士，副主任医师。通讯作者：吴鸿，南昌市第三医院骨科，江西省南昌市330009
