两种入路在经皮椎体后凸成形术中的应用比较

Application comparison of two kinds of approaches in the percutaneous kyphoplasty

目的比较改良经椎弓根入路与传统经椎弓根入路经皮椎体后凸成形术(PKP)治疗腰椎骨质疏松性椎体压缩骨折的临床疗效。方法将60例单节段腰椎骨质疏松性椎体压缩骨折患者按随机数字表法分为A组(采用改良经椎弓根入路PKP治疗,30例)和B组(采用传统经椎弓根入路PKP治疗,30例)。记录两组术后冠状位、矢状位骨水泥分布率,骨水泥渗漏率,术后1年伤椎、邻椎再骨折发生率。结果患者均获得1年随访。冠状位骨水泥分布率A组明显高于B组(P<0.05),矢状位骨水泥分布率两组比较差异无统计学意义(P>0.05)。骨水泥渗漏率及术后1年邻椎、伤椎再骨折发生率A组均明显低于B组(P<0.05)。结论与传统经椎弓根入路相比,改良经椎弓根入路PKP治疗腰椎骨质疏松性椎体压缩骨折能够使骨水泥在椎体内均匀分布,降低骨水泥渗漏率和伤椎、邻椎再骨折发生率。

Objective To compare the clinical effect of percutaneous kyphoplasty(PKP)via modified transpedicular approach and traditional transpedicular approach for treatment of lumbar osteoporotic vertebral compression fractures(OVCFs).Methods The 60 cases of single-segment lumbar OVCFs were divided into group A(30 cases were received modified transpedicular approach)and group B(30 cases were received traditional transpedicular approach),according to random number table.The postoperative bone cement distribution rate of sagittal and coronal position,postoperative bone cement leakage rate,re-fracture rate of injured vertebrae and adjacent vertebrae at 1 year postoperation were observed.Results All cases were followed up for 1 year.Bone cement distribution rate:coronal position in group A was significantly higher than that of group B(P<0.05);there was no significant difference for sagittal position between two groups(P>0.05).The bone cement leakage rate,re-fracture rate of injured vertebrae and adjacent vertebrae at 1 year postoperation of group A were significantly lower than those of group B(P<0.05).Conclusions Compared with traditional transpedicular approach,the modified transpedicular approach PKP for the treatment of lumbar OVCFs have a uniform bone cement distribution,and which decrease the incidence of bone cement leakage,re-fracture rate of injured vertebrae and adjacent vertebrae.