单侧椎弓根旁入路椎体成形术治疗下胸椎压缩性骨折的效果

Effect of vertebroplasty via unilateral parapedicle approach in the treatment of lower thoracic vertebral compression fractures

目的观察单侧椎弓根旁入路椎体成形术治疗下胸椎压缩性骨折的效果。方法选取2017年5月~2018年5月我院收治的60例下胸椎压缩性骨折患者作为研究对象,采用随机数字表法分为对照组和观察组,每组各30例。对照组采用双侧椎弓根旁入路椎体成形术治疗,观察组采用单侧椎弓根旁入路椎体成形术治疗,比较两组骨水泥注射量、手术时间、投射曝光次数、临床效果、视觉模拟量表(VAS)评分和Oswestry功能障碍指数(ODI)评分、并发症发生率。结果两组的骨水泥注射量比较,差异无统计学意义(P>0.05);观察组手术时间短于对照组,投射曝光次数少于对照组,差异有统计学意义(P<0.05);观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);观察组VAS、ODI评分低于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论在下胸椎压缩性骨折治疗中应用单侧椎弓根旁入路椎体成形术能明显缩短手术时间,减少投射曝光次数,临床效果显著,能减轻患者疼痛,尽快恢复功能障碍,并很少出现并发症。

Objective To observe the effect of vertebroplasty in the treatment of compression fractures of the lower thoracic vertebra through unilateral retebral pedicle approach. Methods A total of 60 patients with lower thoracic compression fractures admitted to our hospital from May 2017 to May 2018 were selected as research objects, patients were divided into control group and observation group by random number table method, 30 cases in each group. The control group was received vertebroplasty via bilateral paraspinal approach, while the observation group was received vertebroplasty via unilateral paraspinal approach, the volume of cement injection, operation time, number of projection exposure, clinical effect, visual analogue scale(VAS) and Oswestry dysfunction index(ODI) scores, and the incidence of complications were compared between the two groups. Results There was no significant difference in the amount of bone cement injection between the two groups(P>0.05);the operation time of the observation group was shorter than that of the control group, and the number of projection exposure was less than that of the control group, the differences were statistically significant(P<0.05). The total effective rate of the observation group was higher than that of the control group(P<0.05). The VAS and ODI scores of the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). The total incidence of complications in the observation group was lower than that in the control group, the difference was statistically significant(P <0.05). Conclusion Vertebroplasty through unilateral pedicle approach in the treatment of lower thoracic vertebral compression fracture can significantly shorten the operation time and reduce the number of projection exposure. The clinical effect is remarkable. It can relieve the pain of patients, recover the dysfunction as soon as possible, and there are few complications.