不同入路椎体后凸成形术治疗骨质疏松性椎体压缩骨折 . (Chinese)

Kyphoplasty via different approaches for osteoporotic vertebral compression fractures. (English)

BACKGROUND: Osteoporotic vertebral compression fracture is the most common complication of osteoporosis. Percutaneous kyphoplasty is an effective treatment for osteoporotic vertebral compression fractures. Its operative approaches include unilateral and bilateral pedicle approaches. The two approaches have their advantages and disadvantages. OBJECTIVE: To explore the clinical effect and value of the unipedicular and bipedicular approaches to percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture. METHODS: 383 patients with osteoporotic vertebral compression fractures of the thoracic and lumbar spine were operated on from March 2014 to April 2020 via bipedicular approach (bipedicular group, 208 cases) and unipedicular approach (unipedicular group, 175 cases) percutaneous kyphoplasty. All patients were followed-up using the Oswestry dysfunction index, visual analog scale score and X-ray inspection preoperatively and postoperatively. The operation time, blood loss, amount of bone cement injected, frequency of X-ray exposure, Cobb angle of vertebral kyphosis, vertebral body leading edge height, intermediate height, cement leakage rate, and incidence of adjacent vertebral body re-fracture were measured and compared between the two groups. [ABSTRACT FROM AUTHOR]

背景：骨质疏松性椎体压缩骨折是骨质疏松症最常见的并发症。经皮椎体后凸成形术是骨质疏松性椎体压缩骨折的有效治疗手段，其手术 入路有经单侧、双侧椎弓根入路，两种手术入路存在各自优缺点。 目的：探讨单侧、双侧椎弓根入路经皮穿刺椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床疗效及价值。 方法：2014年3月至2020年4月期间收治胸腰椎骨质疏松性椎体压缩骨折患者383例，分别采用双侧椎弓根入路经皮穿刺椎体成形术治疗(双 侧入路组208例)或单侧椎弓根入路经皮穿刺椎体成形术治疗(单侧入路组175例)。所有患者术前、术后随访均评估Oswestry功能障碍指数 (ODI)、目测类比评分并行X射线片检查，测量并比较两组患者手术时间、出血量、骨水泥填充量、X射线照射次数、椎体后凸Cobb角度、 伤椎椎体前缘高度、中间高度、骨水泥渗漏率及相邻椎体再骨折发生率。 结果与结论：所有患者获得25-98个月(平均43.3个月)的随访。①单侧入路组手术时间、术中出血量、骨水泥注入量、术中X射线曝光次数 均明显少于双侧入路组(P < 0.05)。②单侧及双侧入路组组内目测类比评分、ODI功能指数、椎体后凸Cobb角度、椎体前缘高度及中间高度 术前与术后1个月比较，差异有显著性意义(P < 0.05)，末次随访与术后1个月比较差异无显著性意义(P > 0.05)；末次随访时两组组间比较差 异无显著性意义(P > 0.05)。③骨水泥渗漏率单侧入路组与双侧入路组分别为7.7%(15例/194例)、8.1%(19例/234例)，两组比较差异无显著性 意义(P > 0.05)。④术后相邻非手术椎体骨折发生率单侧与双侧入路组分别为9.1%(16例/175例)、6.3%(13例/208例)，两组比较差异无显著性 意义(P > 0.05)。⑤结果说明，同传统双侧椎弓根入路相比，单侧椎弓根入路经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折临床疗效满 意，同时还可有效缩短手术时间，减少术中出血量及骨水泥注入量，降低骨水泥渗漏风险。 [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)