光电导航引导经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩骨折

Percutaneous kyphoplasty with photoelectric navigation in the treatment of osteoporotic thoracolumbar vertebral fracture

目的观察光电导航引导经皮椎体后凸成形术(PKP)治疗骨质疏松性胸腰椎压缩骨折(OVCF)的准确性和安全性。方法将127例行PKP治疗的OVCF患者随机分为观察组(采用光电导航引导,61例)与对照组(采用常规C臂机透视,66例)。手术前后两组进行疼痛VAS评分,记录X线透视次数、穿刺次数、手术时间及单侧穿刺成功次数,测量伤椎前缘高度比,观察椎弓根突破、骨水泥渗漏情况,记录并发症发生情况。结果患者均获得随访,时间5~13个月。术后24 h VAS评分两组与术前比较差异均有统计学意义(P<0.001),两组间比较差异无统计学意义(P>0.05)。X线透视次数、穿刺次数观察组明显少于对照组(P<0.001),手术时间两组比较差异无统计学意义(P>0.05)。单侧穿刺成功率观察组明显高于对照组(P<0.001)。伤椎前缘高度比术后24 h两组均较术前显著改善(P<0.001),两组间比较差异无统计学意义(P>0.05)。并发症发生率观察组低于对照组(P<0.05)。结论光电导航引导PKP治疗OVCF,穿刺次数少,单侧穿刺成功率高,X线透视次数少,并发症低,安全性更高。

Objective To investigate the accuracy and safety of osteoporotic vertebral compression fracture(OVCF)treated by percutaneous kyphoplasty(PKP)with thoracolumbar photoelectric navigation.Methods The 127 cases of OVCF treated by PKP were randomly divided into observation group(61 cases underwent photoelectric guided)and control group(66 cases underwent C-arm machine navigation).Both groups were evaluated by pain VAS before and after surgery,X-ray exposure frequency,numbers of puncture,operation time and number of successful unilateral puncture in the intraoperation,compression ratio of injuried vertebral anterior edge,pedicle breakthrough and cement leakage,related complications.Results All patients were followed up for 5~13 months.There were statistical differences for two groups of VAS at 24 h postoperation,compared with the preoperation(P<0.001),and there was not statistical difference between two groups(P>0.05).The observation group had less X-ray exposure frequency and numbers of puncture than control group(P<0.001),but operation time difference showed no significance between two groups(P>0.05).The rate of successful unipedicular puncture in observation group was higher than that in control group(P<0.001).At 24 h postoperation,the compression ratio of injuried vertebral anterior edge of each group were significantly improved(P<0.001),but there was no significant difference between the two groups(P>0.05).The complications incidence rate of observation group was lower than that of control group(P<0.05).Conclusions Application of PKP with photoelectric navigation can decrease numbers of puncture,increases success rate of unilateral puncture,reduces rate of X-ray exposure and complications,so that has higher security.