单侧与双侧入路PKP治疗多节段胸腰椎骨质疏松压缩性骨折的早期疗效对比

发布时间：2018-06-05 03:23

本文选题：单侧入路 + 双侧入路　；参考：《苏州大学》2015年硕士论文

【摘要】：目的:比较单侧与双侧入路经皮椎体后凸成形术治疗多节段胸腰椎骨质疏松性压缩骨折的早期临床疗效。方法:回顾性分析2012年1月至2014年12月入院并接受PKP手术治疗的50例多节段胸腰椎骨质疏松压缩性骨折患者,共计123椎,按照手术入路分为双侧入路组25例61椎,单侧入路组25例62椎,对患者术前、术后3天及术后3月进行腰背部疼痛视觉模拟评分(V A S)、术后Cobb角、术椎椎体高度的恢复范围以及手术时间、术中透视次数、骨水泥使用量及骨水泥渗透率的比较。结果:两组患者PKP术均顺利完成。两组患者术后3天及术后3月VAS评分较术前明显降低,P值均0.05,提示两种入路PKP术均能有效缓解OVCF患者疼痛。两组患者术后3天及术后3月椎体高度较术前恢复,P值均0.05,提示两种入路PKP术均能恢复椎体高度,两组间进行对比,P值均0.05,提示两组间椎体高度恢复无统计学差异。两组患者术后Cobb角较术前减小,P值均0.05,提示两种入路PKP术均能纠正脊柱后凸畸形,两组间进行对比,P值均大于0.05,提示两组间cobb角恢复无统计学差异。对比两组间手术时间、术中透视次数、骨水泥使用量,P均0.05,提示两组间具有明显统计学差异。对比两组间骨水泥渗漏率,P大于0.05,提示无明显统计学差异。结论:单侧及双侧入路PKP术治疗多节段胸腰椎骨质疏松压缩性骨折均能达到比较满意的效果。相比较双侧入路,单侧入路PKP术具有手术时间短,放射暴露少,等优点。但单侧穿刺其难度和要求相应提高,而骨水泥的渗漏并不减少。
[Abstract]:Objective: to compare the early clinical effects of unilateral and bilateral percutaneous kyphoplasty in the treatment of multiple thoracolumbar osteoporotic compression fractures. Methods: from January 2012 to December 2014, 50 patients with multiple thoracolumbar vertebral osteoporotic compression fractures who were admitted to hospital from January 2012 to December 2014 and received PKP surgery were retrospectively analyzed. The patients were divided into two groups according to the surgical approach: 25 cases (61 vertebrae) with bilateral approach. In the unilateral approach group, 25 cases (62 vertebrae) were treated with visual analogue score of lumbar and back pain before operation, 3 days after operation and 3 months after operation. The postoperative Cobb angle, the recovery range of vertebral body height, the time of operation, and the times of fluoroscopy were performed. Comparison of bone cement usage and bone cement permeability. Results: PKP was performed successfully in both groups. The VAS scores of the two groups were significantly decreased by 0.05 on the 3rd day after operation and 3 months after operation, indicating that the two approaches of PKP can effectively relieve the pain of OVCF patients. The vertebral body height of the two groups was 0. 05 on the 3rd day after operation and 3 months after operation, indicating that the vertebral body height could be recovered by PKP through the two approaches, and the P value of the two groups was 0. 05, indicating that there was no significant difference in the recovery of the vertebral body height between the two groups. The decrease of Cobb angle after operation in both groups was 0.05, indicating that the two approaches of PKP could correct kyphosis, and the P value of the two groups was greater than 0.05, indicating that there was no significant difference in the recovery of cobb angle between the two groups. The time of operation, the times of fluoroscopy and the dosage of bone cement were 0.05, which indicated that there was significant difference between the two groups. There was no significant difference between the two groups in bone cement leakage rate (P > 0.05). Conclusion: unilateral and bilateral approaches of PKP in the treatment of multiple thoracolumbar vertebral osteoporotic compression fractures can achieve satisfactory results. Compared with bilateral approach, unilateral approach PKP has the advantages of shorter operative time, less radiation exposure, and so on. However, the difficulty and requirement of unilateral puncture are increased, and the leakage of bone cement is not reduced.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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