| 宋鑫,任东林,张锋,韩帅,王健*.压力引导式经皮椎体后凸成形术治疗中段胸椎骨质疏松性椎体压缩性骨折[J].脊柱外科杂志,2020,18(5):300-304. |
压力引导式经皮椎体后凸成形术治疗中段胸椎骨质疏松性椎体压缩性骨折  点此下载全文 (Fulltext) |
| 宋鑫 任东林 张锋 韩帅 王健* |
| 上海市浦东新区人民医院骨科, 上海 201299 |
| 基金项目：浦东新区卫生和计划生育委员会学科建设计划重点专科项目（PWZzk2017-15） |
| DOI：10.3969/j.issn.1672-2957.2020.05.003 |
| 摘要点击次数: 485 |
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| 摘要： |
| 目的 探讨压力引导式经皮椎体后凸成形术（PG-PKP）治疗中段胸椎骨质疏松性椎体压缩性骨折（OVCF）的临床疗效及骨水泥渗漏情况。方法 回顾性分析2017年1月—2019年8月采用PG-PKP和传统PKP治疗的39例中段胸椎OVCF患者临床资料。根据手术方式分为PG-PKP组（A组，20例）和传统PKP组（B组，19例）。记录所有患者术前骨密度、术中骨水泥用量、手术时间及住院时间。测量手术前后X线片上骨折节段椎体前缘高度及后凸Cobb角，评估伤椎恢复情况；在术前CT上测量手术通道影像学参数，在术后CT上观察骨水泥渗漏情况。采用疼痛视觉模拟量表（VAS）评分和Oswestry功能障碍指数（ODI）评估临床疗效。结果 所有手术顺利完成，患者随访3~12（8.64±2.84）个月。手术时间40~90（63.33±13.59）min，住院时间4~8（6.15±1.16）d。2组患者术后1 d和术后3个月的椎体前缘高度、后凸Cobb角、VAS评分、ODI较术前明显改善，差异均有统计学意义（P < 0.05）。2组骨水泥注入量和骨水泥渗漏率差异有统计学意义（P < 0.05）。A组骨水泥渗漏率为10.00%（2/20），B组为26.32%（5/19）。术后切口均一期愈合，无骨水泥渗漏致脏器栓塞及脊髓、神经根受压等并发症发生。结论 与传统PKP相比，PG-PKP治疗中段胸椎OVCF临床疗效及影像学指标恢复满意，骨水泥渗漏率低，值得临床推广。 |
| 关键词：胸椎 骨质疏松 脊柱骨折 骨黏合剂 椎体后凸成形术 |
| Pressure-guided percutaneous kyphoplasty for treatment of mid-thoracic osteoporosis vertebral compression fracture Fulltext |
| SONG Xin REN Dong-lin ZHANG Feng HAN Shuai WANG Jian* |
| Department of Orthopaedics, Pudong New Area People's Hospital, Shanghai 201299, China |
| Fund Project: |
| Abstract: |
| Objective To investigate the clinical efficacy and the leakage of bone cement of pressure-guided percutaneous kyphoplasty（PG-PKP） in the treatment of mid-thoracic osteoporosis vertebral compression fracture（OVCF）. Methods From January 2017 to August 2019，the clinical data of 39 patients diagnosed as mid-thoracic OVCF were retrospectively analyzed. According to the type of operation，20 patients adopting PG-PKP were included in group A，and 19 adopting traditional PKP in group B. The preoperative bone mineral density，intraoperative bone cement injection volume，operation time and hospital stay of all the patients were recorded. The recovery of the injured vertebra was evaluated by measuring the height of the anterior vertebrae and the Cobb's angle of the kyphosis on X-ray before and after surgery. The imaging parameters of operation channel were measured on preoperative CT，and the cement leakage was observed on postoperative CT. The visual analog scale（VAS） score and Oswestry disability index（ODI） were used to evaluate the clinical efficacy. Results All the operations were successfully completed，and the patients were followed up for 3-12（8.64±2.84）months. The operation time was 40-90 （63.33±13.59）min，and the hospital stay was 4-8（6.15±1.16）d. The height of the anterior vertebrae，Cobb's angle of the kyphosis，VAS score and ODI of both groups were significantly improved at postoperative 1 d and 3 months compared with before surgery，all with a statistically significant difference（P < 0.05）. There were also statistically significant differences between the 2 groups in the bone cement injection volume and leakage rate（P < 0.05）. The bone cement leakage rate was 10.00%（2/20） in group A and 26.32%（5/19） in group B. All the incisions healed by first intenion. There were no other complications such as organ embolism，spinal cord and nerve root compression caused by bone cement. Conclusion Compared to traditional PKP，the clinical efficacy and imaging index of PG-PKP in the treatment of mid-thoracic OVCF is satisfactory，and the leakage rate of bone cement is low，thus being worthy of wider clinical application. |
| Keywords:Thoracic vertebrae Osteoporosis Spinal fracture Bone cements Kyphoplasty |
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