目的:通过比较单侧经椎弓根外入路与双侧经椎弓根入路椎体成形术(PVP)治疗骨质疏松性椎体压缩性骨折(OVCF)的疗效,探讨单侧经椎弓根外入路手术方式的优势及可行性。方法:回顾性分析2017年1月至2019年12月于我院行PVP手术的65例OVCF患者的临床资料,根据手术方式分为单侧经椎弓根外入路组(简称单侧组,35例)和双侧经椎弓根入路组(简称双侧组,30例),比较两组手术时间、骨水泥注入量、术中X线透视次数、骨水泥渗漏例数、术后住院时间、手术前后视觉模拟评分法(VAS)评分、手术前后Cobb角等临床指标,探讨两种手术方式的优劣势。结果:单侧组的手术时间和术中X线透视次数均明显小于双侧组(P＜0.001),但双侧组的骨水泥量要多于单侧组(P＜0.001),两组在骨水泥渗漏例数、术后住院时间、术后并发症发生率、手术前后VAS评分和手术前后Cobb角等方面差异无统计学意义(P＞0.05)。结论:单侧经椎弓根外入路PVP在保证手术治疗效果的同时,缩短了手术时间,大大降低了透视次数,是治疗OVCF较为可靠的手术方式。 |
Objective: To compare the efficacy of unilateral transpedicular external approach and bilateral transpedicular vertebroplasty in the treatment of osteoporotic vertebral compression fractures(OVCF), and explore the advantages and feasibility of unilateral transpedicular external approach. Methods: The data of 65 OVCF patients who underwent percutaneous vertebroplasty(PVP) surgery in our hospital from January 2017 to December 2019 were retrospectively analyzed. According to the operation method, they were divided into unilateral transpedicular external approach surgery group(35 cases) and bilateral transpedicular approach surgery group(30 cases). Operation time, bone cement injection volume, intraoperative fluoroscopy times, bone cement leakage rate, postoperative hospital stay, VAS score and Cobb angle were compared between the two groups to study their advantages and disadvantages. Results: The operation time and the frequency of intraoperative fluoroscopy in the unilateral PVP group were significantly less than those in the bilateral PVP group(P＜0.001), but the amount of bone cement in the bilateral PVP group was larger than that in the unilateral PVP group(P＜0.001). There were no statistically significant differences in bone cement leakage rate, postoperative hospital stay, postoperative complication rate, VAS score and Cobb angle(P＞0.05) between the two groups. Conclusion: Unilateral transpedicular external approach PVP can not only ensure the effect of surgical treatment, but also shorten the operation time and greatly reduce the times of fluoroscopy. It is a more reliable surgical method for the treatment of OVCF. |
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