管状位穿刺法经单侧椎弓根腰椎体成形术的疗效研究

Study on the Curative Effect of Unilateral Pedicle Lumbar Vertebroplasty with Tubular Puncture

目的:探讨管状位穿刺法经单侧椎弓根腰椎体成形术的疗效。方法:回顾性分析2017年7月~2020年7月某院收治的老年骨质疏松性压缩性骨折行椎体成形术治疗的患者82例,根据穿刺方式分为管状位穿刺组和双平面投照穿刺组,管状位穿刺的患者44例,双平面投照穿刺患者38例,比较两组的手术时间、术中出血量、术中X线的投照次数、术后VAS评分、术中骨水泥填充量、骨水泥渗漏发生率及局部的Cobb角。结果:管状位穿刺组的手术时间、手术出血量及术中X线的投照次数少于双平面投照穿刺组,差异有统计学意义(P<0.05);管状位穿刺组术中骨水泥填充量、术中水泥渗漏发生率少于双平面投照穿刺组,差异有统计学意义(P<0.05);术前两组VAS评分无明显差异(P>0.05),术后管状位穿刺组的VAS评分低于双平面投照穿刺组,差异有统计学意义(P<0.05),术前术后两组局部的Cobb角无明显差异(P>0.05)。结论:管状位穿刺较双平面投照穿刺手术时间短、术中出血量少,术中X线的投照时间少于双平面投照组,术中骨水泥填充量、术中水泥渗漏发生率少于双平面投照组,具有更好的临床效果,可作为老年腰椎骨质疏松性压缩性骨折经单侧椎弓根腰椎体成形术优先穿刺方式。

Objective:To investigate the effect of unilateral pedicle lumbar vertebroplasty with tubular puncture.Methods:A retrospective analysis was performed on 82 elderly patients with osteoporotic compression fractures who underwent vertebroplasty in a hospital from July 2017 to July 2020.According to the puncture method,all patients were divided into the tubular puncture group(44 patients)and the biplanar puncture group(38 patients).Operative time,intraoperative blood loss,intraoperative X-ray frequency,postoperative VAS score,intraoperative bone cement filling amount,incidence of bone cement leakage and local Cobb angle were compared between the two groups.Results:The operative time,the amount of bleeding and the frequency of intraoperative X-ray irradiation in the tubular puncture group were less than those in the biplanar puncture group,and the difference was statistically significant(P<0.05).The amount of intraoperative bone cement filling and the incidence of postoperative cement leakage in the tubular puncture group were lower than those in the biplanar puncture group,with statistically significant difference(P<0.05).There was no significant difference in VAS score between the two groups before surgery(P>0.05).The postoperative VAS score in tubular puncture group was lower than that in the biplanar puncture group,and the difference was statistically significant(P<0.05).There was no significant difference in local Cobb angle between the two groups before and after surgery(P>0.05).Conclusion:Compared with the biplanar puncture,the tubular puncture has shorter operation time,less intraoperative bleeding,less intraoperative X line exposure time,and the intraoperative cement filling amount and the incidence of intraoperative cement leakage are less than those in the biplanar puncture group,which has better clinical effect and can be used as the preferred puncture method of unilateral pedicle lumbar vertebroplasty for senile lumbar osteoporotic compression fracture.