弯角PVP技术治疗骨质疏松性椎体压缩骨折的疗效观察

Effect of curved PVP in the treatment of osteoporotic vertebral compression fracture

目的应用弯角输送装置行单侧PVP技术治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compressive fractures,OVCF),观察其临床疗效。方法选择2015-07-2016-07收治的32例OVCF患者,均采用单侧PVP技术治疗,术中采用弯角设计的输送装置行骨水泥填充操作。术后均随访8-13个月,观察其临床疗效。结果所有患者均顺利完成手术,手术时间平均为29.3min,X线曝光次数平均9.3次;术中7例发生骨水泥渗漏,发生率为21.88%;术后伤椎骨水泥均呈对称性分布,无一例偏侧分布。与术前相比,术后2 d、末次随访时的VAS评分和ODI指数均显著降低,且伤椎前缘相对高度有一定程度的矫正效果,上述差异均有统计学意义(P<0.05)。随访期间,无一例患者发生伤椎塌陷或邻椎再发骨折现象。结论采用弯角PVP技术单侧穿刺治疗OVCF,其手术时间短、术中X线暴露次数少,骨水泥分布满意,且骨水泥渗漏率相对较低,临床疗效可靠。

Objective To observe the clinical efficacy of unilateral PVP technology with curved delivery system in the treatment of osteoporotic vertebral compressive fractures（OVCF）. Methods A total of 32 OVCF patients were selected from July 2015 to July 2016. They were all treated by unilateral PVP technique. All the patients were followed up for 8-13 months, and the clinical effect was observed. Results All patients completed the operation successfully, the average operative time was 29.3 min. The average X-ray exposure times was 9.3 times. The incidence rate of cement leakage was 21.88%（7 cases）. The postoperative vertebral cement was symmetrical, and no case was unilateral.Compared with preoperation, the VAS score and ODI index at 2 d after operation and at the last follow-up were significantly decreased, and the relative height of the anterior edge of injured vertebrae was corrected to some extent. The above indicators had statistically significant differences（P 0.05）.During the follow-up period, no vertebral collapse or vertebral recurrent fracture occurred. Conclusion Unilateral OVCF puncture treated with curved PVP technique has shorter operative time, less intraoperative X-ray exposure, better bone cement distribution and lower bone cement leakage rate.