单双侧椎弓根入路经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的疗效分析

Therapeutic effect of unilateral and bilateral pedicle approach percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures

目的比较分析单双侧椎弓根入路经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折(OVCF)的疗效。方法回顾分析2016年4月至2017年6月河南大学第一附属医院应用单双侧椎弓根入路PVP治疗OVCF患者76例的临床资料,根据手术方式分为单侧组(单侧椎弓根入路)42例和双侧组(双侧椎弓根入路)34例。比较两组的手术时间、术中X线透视次数、骨水泥注入量,恢复椎体高度以及并发症情况,同时使用腰腿痛视觉模拟评分(VAS)及Oswestry功能障碍指数(0DI)评分来评估患者的恢复情况。结果单侧组手术时间[(33.01 ±3.78) min]、术中X线透视次数[(22.06 ±3.85)次]和骨水泥注入量[(3.53 ±0.42)mL]均少于双侧组(t=8.54、5.98、4.74,均P<0.05)。两组患者的恢复椎体高度和并发症均差异无统计学意义(均P>0.05)。两组患者的术后VAS及ODI评分均较术前降低(均P<0.05)。结论在适应证选择合理的情况下,单侧入路PVP优于双侧,对于OVCF应首选单侧入路PVP治疗。

Objective To explore the efficacy of percutaneous vertebroplasty ( PVP) in the treatment of osteoporotic vertebral compression fractures ( OVCF).Methods A retrospective analysis of 76 patients with OVCF treated with single and double pedicle approach PVP from April 2016 to June 2017 in the First Affiliated Hospital of Heznan University was conducted.According to the operation method, the patients were divided into unilateral group (42 patients, unilateral pedicle approach),and bilateral group (34 cases, bilateral pedicle approach ).The operation time,number of intraoperative X - rays, amount of bone cement injection, height of the vertebral body and the complications were compared between the two groups.The visual analogue scale ( VAS) and the Oswestry dysfunction index( ODI) score were used to assess the recovery of the patients.Results The unilateral group had less operative time[(33.01 ± 3.78 ) min ], intraoperative X - ray number [( 22.06 ± 3.85 ) times ] and bone cement injection [(3.53 ± 0.42 ) mL] compared with the bilateral group ( t = 8.54,5.98,4.74, all P < 0.05 ).There were no statistically significant differences in the recovery of vertebral height and complications between the two groups ( all P >0.05).The postoperative VAS and ODI of the two groups were significantly improved compared with those before operation (all P <0.05).Conclusion In the case of reasonable indications, the unilateral approach PVP is better than bilateral, and unilateral approach PVP should be the first choice for OVCF.