单侧经椎弓根外入路经皮椎体成形术治疗骨质疏松性椎体压缩骨折

Percutaneous vertebroplasty with uni-extrapedicular approach for treatment of osteoporotic vertebral compression fractures

目的探讨单侧经椎弓根外入路经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折(OVCF)的早期临床疗效。方法对92例OVCF患者采用单侧经椎弓根外入路PVP治疗。记录手术时间、骨水泥注入量及术后并发症发生情况,比较手术前后疼痛VAS评分及伤椎前缘高度比。结果手术时间16~29(20.32±3.41)min,骨水泥每椎注入量4~7(5.42±1.01)ml。术后患者疼痛均得到明显缓解,18例发生骨水泥渗漏,未发生其他严重并发症。伤椎前缘高度比术后与术前比较差异无统计学意义(P>0.05)。患者术后均获得1周随访。疼痛VAS评分术后2、7 d与术前比较差异均有统计学意义(P<0.05),术后两时间点间比较差异无统计学意义(P>0.05)。结论单侧经椎弓根外入路PVP治疗OVCF安全、手术时间短、创伤小,能有效改善患者疼痛症状,早期效果良好,但对椎体高度恢复效果欠佳。

Objective To investigate the early clinical effect of percutaneous vertebroplasty(PVP)with uni-extrapedicular approach for treatment of osteoporotic vertebral compression fractures(OVCF).Methods The 92 cases of OVCFs were treated with PVP via uni-extrapedicular approach.The operation time,the injection volume of bone cement and the postoperative complications were recorded;pre-and post-operative pain VAS and the height ratio of injured vertebral anterior edge were compared.Results Operation time was 16~29(20.32±3.41)min,the bone cement injection volume was 4~7(5.42±1.01)ml per vertebra.The postoperative symptoms were obviously relieved in all patients,18 patients had bone cement leakage,without other serious complications.There was no statistical difference in the pre-and post-operative height ratio of the injured vertebral anterior edge(P>0.05).All patients were received 1 week of follow-up.There were statistical differences in pain VAS between the preoperative and postoperative 2,7 d(P<0.05),there was no significant difference at two time points after operation(P>0.05).Conclusions PVP with uni-extrapedicular approach is used for treatment of OVCF,which is safe,short operation time and less trauma,and can effectively improve the patient′s pain symptoms,the early effect is good,but vertebral height is not significantly improved.