管状位穿刺经单侧椎弓根入路椎体成形术治疗老年骨质疏松性压缩性骨折的疗效分析

Curative effect of tubular puncture through unilateral transpedicular vertebroplasty in the treatment of fractures of osteoporotic compression

目的探讨管状位穿刺经单侧椎弓根入路椎体成形术治疗老年骨质疏松性压缩性骨折的疗效分析。方法回顾性分析2013年10月~2016年11月我院收治的老年骨质疏松性压缩性骨折并行椎体成形术治疗患者70例的临床资料,根据其手术方法分为管状位穿刺经单侧椎弓根入路椎体成形术(单侧)组和双侧椎弓根入路椎体成形术(双侧)组,各35例。观察比较两组患者临床治疗效果、手术时间、骨水泥填充量、术中X线照射次数、术后视觉模拟疼痛(VAS)评分及Oswestry功能障碍指数(ODI)评分及并发症情况。结果单侧组患者术后优良率为94.28%优于双侧组(74.29%),差异有统计学意义(P<0.05);单侧组患者手术时间、骨水泥填充量及术中X线照射次数均较双侧组少,差异有统计学意义(P<0.001);术前,两组患者VAS评分和ODI评分相比,差异无统计学意义(P>0.05);术后,两组患者VAS评分和ODI评分较术前明显下降,且单侧组下降幅度较双侧组大,差异有统计学意义(P<0.001);单侧组渗漏发生率为5.72%较双侧组(11.43%)低,但两组渗漏发生率差异无统计学意义(P>0.05)。结论管状位穿刺经单侧椎弓根入路椎体成形术治疗老年骨质疏松性压缩性骨折,临床效果确切,且手术时间短,骨水泥填充量少,术中X线照射次数少,患者放射暴露减少等优点,可作为老年骨质疏松性压缩性骨折治疗的首选治疗方案。

Objective To investigate the effect of tubular needle aspiration through unilateral transpedicular vertebroplasty in the treatment of fractures of osteoporotic compression. Methods The clinical data of 70 cases of osteoporotic compression fractures of vertebral body parallel from October 2013 to November 2016 in our hospital were retrospectively analyzed. According to the operation method, they were divided into tubular puncture by Dan Ce transpedicular vertebroplasty （unilateral） group and bipedicular vertebroplasty （bilateral） group, with 35 cases in each. The clinical curative effect, operation time, bone cement filling, intraoperative X-ray exposure times, postoperative （VAS） score and Oswestry disability index （ODI） score and complications of the two groups were compared and observed. Results The excellent rate of unilateral group was 94.28%, which was higher than that of bilateral group （74.29%）, the difference was statistically significant （P 〈 0.05） .The operation time, bone cement filling and intraoperative X-ray exposure times of unilateral group were less than those of bilateral group, the difference was statistically significant （P 〈 0.001）. Before operation, there was no significant difference in VAS score and ODI score between the two groups （P 〉 0.05）. After operation, the VAS score and ODI score of the two groups were significantly lower than those before the operation, and the decrease rate of the unilateral group was higher than that of the bilateral group, and the difference was statistically significant （P 〈 0.001）. The incidence of leakage in the unilateral group was 5.72%, which was lower than that in the bilateral group （11.43%）, but there was no significant difference between the two groups （P 〉 0.05）. Conclusion The tubular puncture through unilateral transpedicular vertebroplasty in the treatment of osteoporotic compression fractures has good clinical efficacy, and short operation time, less amount of bone cement filling, intraoperative X-ray irradiation fewer patients with radiation exposure reduction advantages in elderly osteoporotic compression treatment of fracture treatment.