单侧与双侧入路经皮椎体成形术治疗椎体压缩性骨折临床疗效的比较

Curative effectiveness of PVP by trans-single-pedicle approach VS trans-both-pedicles approach for vertebral compression fractures

目的比较单侧入路与双侧入路经皮椎体成形术（PVP）治疗椎体压缩性骨折临床疗效的异同。方法62例（62节）单一椎体压缩性骨折患者，在C臂机下，24节椎体行双侧经椎弓根入路、38节行单侧经椎弓根入路经皮椎体成形术。采用椎体前、中柱高度恢复程度、椎体后凸Cobb角及VAS评分进行手术疗效比较。结果术后1d、3个月时，两组椎体后凸Cobb角、VAS评分较术前均有改善（P〈0．05）。术后1d双侧组与单侧组比较，椎体高度、椎体后凸Cobb角恢复率、VAS评分差异有统计学意义（P〈0．05），而术后3个月时，VAS评分差异无统计学意义（P〉0．05）。结论不同入路经椎弓根椎体成形术中，椎体高度恢复率、椎体后凸Cobb角、早期VAS评分的改善双侧组优于单侧组；中期VAS评分两组疗效差异无统计学意义。

Objective To compare the curative effectiveness of percutaneous vertebroplasty （PVP） by trans-single-pedicle approach or trans-both-pedicles approach for vertebral compression frac- tures. Method The clinical data of 62 patients with 62 vertebral compressive fractures from October 2009 to December 2011 were retrospectively reviewed. Under the guidance of C-arm X-ray, all the fractures were repaired with PVP,including 24 vertebrae of trans-both-pedicles approach and 38 vertebrae of trans-both- pedicles approach. Clinical outcomes were quantified by the restoration rate of vertebral height, Cobb angle and visual analogue scale （~AS）. Results On the 1 st day and 3rd months after operation, Cobb angle and ~AS were statistically improved in either trans-single-pedicle approach group or trans-both-pedicles ap- proach group（ P 〈 0.05 ）. There were also statistical differences between the two groups in restoration rate of vertebral height, Cobb angle and VAS on the 1 st day after operation, while the VAS didnt show statisti- cal difference at the 3rd months postoperatively. Conclusion In trans-both-pedicles approach group,there were better improvements in restoration rate of vertebral height, Cobb angle and early postoperative VAS than that in trans-single-pedicle approach group. There was no significant difference between the two groups in Mid-termare VAS.