单侧与双侧入路行椎体成形术治疗老年骨质疏松性椎体压缩骨折的效果

Effect of unilateral and bilateral approach for vertebroplasty in the treatment of senile osteoporotic vertebral compression fractures

目的比较老年骨质疏松椎体压缩骨折(OVCF)采取单侧与双侧入路行椎体成形术治疗的效果。方法选择我院接受治疗的OVCF患者95例(116椎),按照数字随机原则分成观察组(48例,59椎)及对照组(47例,57椎),分别给予经皮单侧及双侧入路椎体成形微创手术方案治疗。比较两组手术时间、术中出血量、骨水泥灌注量、术前及随访后VAS疼痛评分、ODI指数及术后骨水泥渗漏发生情况等。结果观察组手术时间、术中出血量、骨水泥灌注量均优于对照组(P<0.05)。末次随访时,两组患者的VAS评分及ODI指数均降低(P<0.05)。两组患者末次随访时的VAS评分、ODI指数及术后骨水泥渗漏率比较,差异不显著(P>0.05)。结论 OVCF经手法复位后,经单侧椎体成形术治疗能够获得良好的临床效果。

Objective To compare the efficacy of vertebroplasty with unilateral and bilateral approaches in the treatmentof osteoporotic vertebral compression fractures （OVCF） in the elderly. Methods A total of 95 patients （116 vertebrae） withOVCF treated in our hospital were divided into observation group （48 cases, 59 vertebrae） and control group （47 cases, 57vertebrae） according to the random number principle, who were treated by vertebroplasty with unilateral and bilateralapproaches respectively. The operative time, intraoperative blood loss, volume of bone cement, VAS pain scores, ODI indexesbefore surgery and after following-up and postoperative cement leakage in the two groups were compared. Results The operationtime, intraoperative blood loss, volume of bone cement in the observation group were better than those in the control group（P〈0.05）. At the last follow-up, the VAS scores and ODI indexes in the two groups decreased（P〈0.05）. At the last follow-up, theVAS scores, ODI indexes and postoperative cement leakage rates in the two groups were not significantly different（P〉0.05）.Conclusion After manual reduction, vertebroplasty with unilateral approach in senile OVCF can achieve good clinical effect.