单侧穿刺囊袋加压椎体成形术治疗胸腰椎骨质疏松性骨折

Unilateral puncture bag compression vertebroplasty in treatment of thoracolumbar osteoporotic fractures

目的探讨单侧穿刺囊袋加压椎体成形术治疗胸腰椎骨质疏松性骨折的临床疗效。方法对35例胸腰椎骨质疏松性骨折患者行单侧穿刺囊袋加压椎体成形术治疗。观察骨水泥渗漏情况、疼痛VAS评分和伤椎椎体高度恢复情况。结果患者均顺利完成手术。手术时间35~96(52.20±15.59)min;术中出血量2~15(6.06±2.66)ml。未出现骨水泥渗漏及肺栓塞。患者均获得随访,时间12~24(17.00±3.33)个月。术后3 d、术后1个月及末次随访时,VAS评分较术前明显下降(P<0.05),伤椎椎体前缘、中部高度比及Cobb角较术前明显改善(P<0.05)。结论单侧穿刺囊袋加压椎体成形术治疗胸腰椎骨质疏松性骨折具有微创、骨水泥渗漏率低、疗效确切的优点,但其安全性仍需大样本进行远期观察。

Objective To investigate the clinical efficacy of unilateral puncture bag compression vertebroplasty in the treatment of thoracolumbar osteoporotic fractures.Methods The 35 cases of thoracolumbar osteoporotic fractures were treated with unilateral puncture bag compression vertebroplasty.The bone cement leakage situation,pain VAS and the height recovery of the injuried vertebrae were observed.Results All 35 patients were successfully finished operation,the operation time was 35~96(52.20±15.59)min,the intraoperative bleeding volume was 2~15(6.06±2.66)ml.No serious complications such as pulmonary embolism and bone cement leakage occurred during the operation.All cases were followed up from 12 months to 24 months,average(17.00±3.33)months.VAS of postoperative 3 d,1 month and final follow-up were significantly decreased,compared with the preoperation(P<0.05);the anterior margin,middle height of the injuried vertebrae and Cobb angle were significantly improved after operation than the preoperation(P<0.05).Conclusions Unilateral puncture bag compression vertebroplasty for osteoporotic fracture of thoracolumbar vertebrae has the advantages of minimally invasive,low probability of cement leakage and good curative effect,while its safety still needs long-term observation with large samples.