单侧经椎体侧方后上角穿刺入路在经皮穿刺椎体成形术中的应用

Application of unilateral vertebral body puncture from side top corner in PVP

目的探讨单侧经椎体侧方后上角穿刺入路在经皮穿刺椎体成形术中的应用。方法选取2014年1月-2016年3月针对伤椎椎弓根直径细小、椎弓根外展角度较小的老年性骨质疏松椎体压缩性骨折患者18例,采用单侧经椎体侧方后上角穿刺入路行经皮穿刺椎体成形术治疗,分别记录术前1天,术后3 d、1个月和3个月的视觉模拟评分(VAS)及Oswestry功能障碍指数(ODI)以评估治疗效果。结果所有患者均顺利完成手术,骨水泥注入通道尖端可顺利到达椎体中线,椎体内骨水泥填充满意。无血管、神经损伤等严重并发症发生。术后患者疼痛症状均有减轻,随访3~12个月,术后VAS评分及ODI值较术前均降低(P<0.05)。结论在伤椎椎弓根直径细小及椎弓根外展角度较小时,采用单侧经椎体侧方后上角穿刺入路行经皮穿刺椎体成形术可行、有效。

Objective To investigate the application of unilateral vertebral body puncture approach fromside top corner in percutaneous vertebroplasty （PVP）. Methods Eighteen patients with senile osteoporoticvertebral compression fractures from January 2014 to March 2016 were studied retrospectively. The patientswith small diameter and transverse angle of the pedicles were treated with PVP by unilateral vertebral bodypuncture from side top corner. Visual analogue scale （VAS） and Oswestry disability index （ODI） were recordedon the last preoperative day, the 3rd day, the 1st and the 3rd month after surgery to judge therapeutic effect.Results The patients all successfully underwent surgery that the point of bone cement injection channel didarrive vertebral body center line and the bone cement injection fully filled. There were no severecomplications such as blood vessels, nerve damage, etc. The patients were followed up for 3-12 months aftersurgery, whose pain was significantly reduced. Postoperative VAS score and ODI value were significantly lowerthan those of the preoperative ones （ 〈 0.05）. Conclusions Unilateral vertebral body puncture from side topcorner in PVP is feasible and effective to the patients with small diameter and transverse angle of thepedicles.