经皮支柱块治疗胸腰椎压缩骨折

Percutaneous intravertebral pillar implanting for treatment of thoracolumbar vertebral compression fractures

目的观察经皮支柱块治疗单纯胸腰椎压缩骨折疗效。方法采用经皮穿刺经双侧椎弓根支柱块置入术治疗33例胸腰椎压缩性骨折患者。结果 33例患者共植入支柱块66枚,术后无神经并发症发生。手术时间35～57（40.8±6.3）min,手术切口长度1.5～2.0（1.7±0.3）cm,术中失血量18～40（25.7±8.3）ml。患者均获随访,时间10～22（15.4±2.3）个月。VAS评分：术前7～10（8.0±1.6）分,术后1～3（2.4±0.8）分;Cobb角：术前20°～35°（25.2°±6.1°）,术后6°～13°（9.7°±2.5°）;伤椎前缘高度：术前45%～60%（49.6%±6.3%）,术后75%～91%（82.7%±5.3%）。VAS评分、Cobb角、伤椎前缘高度术前术后比较差异均有统计学意义（P〈0.05）。结论经皮支柱块治疗胸腰椎压缩性骨折的短期疗效满意,创伤小,并发症少。

Objective To evaluate the effect of percutaneous intravertebral for treatment of thoracolumbar vertebral compression fracture. Methods 33 patients with thoracolumbar vertebral compression fractures were treated by percutaneous intravertebral pillar. Results 33 vertebral bodies were treated by percutaneous intravertebral pillar implanting 66 gold. All patients successfully underwent the surgery without nervous complications. The operation time was 35 ～ 57（ 40. 8 ± 6. 3） min,the incision length was 1. 5 ～ 2. 0（ 1. 7 ± 0. 3） cm,blood loss was 18 ～ 40（ 25. 7 ±8. 3） ml. All cases were followed up for 10 ～ 22（ 15. 4 ± 2. 3） months. VAS was 7 ～ 10（ 8. 0 ± 1. 6） preoperatively and 1 ～ 3（ 2. 4 ± 0. 8） postoperatively. The Cobb angle was 20° ～ 35°（ 25. 2° ± 6. 1°） preoperatively and 6° ～ 13°（ 9. 7° ± 2. 5°） postoperatively. The preoperative vertebral height was 45% ～ 60%（ 49. 6% ± 6. 3%）,and it was recovered to 75% ～ 91%（ 82. 7% ± 5. 3%） postoperatively. There were significant difference of Cobb angle,vertebral height and VAS（ P〈0. 05）. Conclusions Percutaneous intravertebral pillar procide satisfactory clinical outcomes in treatment of thoracolumbar vertebral compression fractures and have advantages of minimal invasion and less complications.