老年骨质疏松脊柱压缩骨折应用单侧与双侧入路椎体成形术临床疗效对比

高翔 张旭鸣 何武兵 林昊 许玮

【摘要】 目的：探討应用单侧穿刺入路椎体成形术及双侧穿刺入路椎体成形术在老年骨质疏松脊柱压缩性骨折中的临床疗效。方法：选取笔者所在医院于2015年10月-2018年6月收治的53例单节段骨质疏松脊柱压缩性骨折患者（无脊髓神经损伤），根据手术入路方式不同分为单侧穿刺组（单侧穿刺入路椎体成形术）及双侧穿刺组（双侧穿刺入路椎体成形术），比较手术治疗前后的临床表现和术中操作情况如伤椎前缘高度、Cobb角度、视觉模拟评分（visual analogue scale，VAS）、手术时间及骨水泥用量。结果：本组53例术后随访6个月～3年，平均22个月，术后两组病例伤椎前缘高度、Cobb角度及VAS评分均较术前有改善，两组病例在术后Cobb角度、伤椎前缘高度及VAS评分比较，差异均无统计学意义（P>0.05）;双侧穿刺组较单侧穿刺组骨水泥用量多，手术时间长（P<0.05）。结论：采用经单侧穿刺入路手术时间方面优于双侧穿刺入路，双侧穿刺入路骨水泥用量较多，填充量较单侧穿刺组满意。

【关键词】 单侧穿刺入路椎体成形术; 双侧穿刺入路椎体成形术; 骨质疏松脊柱压缩骨折; Cobb角度; 骨水泥; VAS评分

doi：10.14033/j.cnki.cfmr.2019.27.028 文献标识码 B 文章编号 1674-6805（2019）27-00-04

Comparison of Clinical Efficacy between Unilateral Approach Vertebroplasty and Bilateral Approach Vertebroplasty for Osteoporosis Spinal Compression Fractures in the Elderly/GAO Xiang，ZHANG Xumin，HE Wubin，et al.//Chinese and Foreign Medical Research，2019，17（27）：-67

【Abstract】 Objective：To explore the clinical effects of unilateral puncture approach vertebroplasty and bilateral puncture approach vertebroplasty in patients with osteoporosis spinal compression fractures.Method：From October 2015 to June 2018，53 cases of patients with segmental osteoporotic spinal compression fractures（without spinal cord injury）in our hospital were selected.According to the different surgical approaches，the patients were divided into unilateral puncture group（unilateral puncture approach vertebroplasty）and bilateral puncture group（bilateral puncture approach vertebroplasty）.Before and after surgical treatment，the clinical manifestation and intraoperative operating conditions such as vertebral body height recovery，Cobb angle，visual analogue scale（VAS）score were observed，and the bone cement dosage and operation time were anylzed.Result：This group of 53 cases of postoperative were follow-up of 6 months to 3 years，an average of 22 months，the anterior margin height，Cobb angle and VAS score of the two groups were improved than before.There was no significant statistical differences between the two groups of cases on postoperative Cobb angle，the anterior margin height and VAS score（P>0.05）.The bone cement dosage was more in the bilateral approach group than that in the unilateral approach group，and the operation time of bilateral puncture approach group was longer than that of unilateral puncture approach group（P<0.05）.Conclusion：The operation time of the unilateral puncture approach is better than that of the bilateral puncture approach.The amount of bone cement in the bilateral puncture is more，and the filling volume is satisfactory compared with the unilateral puncture.

【Key words】 Unilateral puncture approach vertebroplasty; Bilateral puncture approach vertebroplasty; osteoporosis spinal compression fractures; Cobb Angle; Bone cement; VAS score

First-authors address：Fujian Provincial Hospital，FuZhou 350001，China

椎体成形术是一种脊柱微创手术疗法，其原理为通过专用手术器械通道向椎体内注入凝固性材料以达到减轻疼痛和增加椎体稳定性的目的[1]。1984年Galibert等[2]于法国亚眠（Amiens）首次在患有侵袭性血管瘤的C2椎体内注入医用骨水泥，术后疼痛症状缓解，其后于1987年作者报道7例类似操作并将其命名为椎体成形术，由于该手术经皮穿刺操作，故又称之为“经皮椎体成形术”（percuteneous vertebroplasty，PVP）。我国在20世纪末和21世纪初开展这项手术，早期国内学者……