单侧椎弓根入路椎体成形术治疗胸腰段椎体压缩性骨折的临床应用

The Clinical Application of Vertebroplasty Through Unilateral Pedicle Approach in Treatment of Thoracolumbar Compression Fracture

目的探讨单侧椎弓根入路经皮椎体成形术治疗胸-腰段椎体压缩性骨折的临床疗效。方法选择2010年8月-2017年06月收治220例胸、腰椎压缩性骨折患者,均行MRI检查,诊断为新鲜骨折,共涉及263个椎体,均行单侧椎弓根入路穿刺,行PVP术,记录手术时间、骨水泥填充量、住院天数,疼痛评分及功能活动评估。结果平均手术时间35 min,平均骨水泥填充量4.6 mL,平均住院时间6.5 d,168例患者术后疼痛完全缓解,52例患者术后疼痛部分缓解,无轻微缓解及不缓解患者,术后1周212例患者活动无明显困难,8例患者行走困难,术后平均随访3个月,无不良反应及并发症。结论 C形臂引导下经皮单侧椎弓入路椎体成形术,穿刺成功率高,效果良好,创伤小、并发症少,有效地解除了由于椎体压缩性骨折引起的多种临床症状。

Objective To explore the techniques and effects of percutaneous vertebroplasty through unilateral pedicle approachin treatment of thoracolumbar compression fracture. Methods 220 patients(263 vertebrae) were diagnosed as vertebral compression fractures by examination of DR,CT and MRI. Bone cement was injected under C-arm guidance. The injection amount and compression expansion in the vertebral body injected were carefully observed. The effects and complications were also observed.Results Bone cement was injected into 263 vertebrae through unilateral pedicle approach and 5 vertebrae through bilateral approach.220 cases were followed-up for 1-36 months.Pain disappeared in 98 cases and relieved in 9 cases. There was no complications.Conclusions The unilateral percutaneous vertebroplasty can relieve clinical symptoms caused by vertebral compression fracture. It has advantages of high successful rate of injection,good effects,less operation time,less X-ray radiation time, minimal trauma, less complications.