单侧与双侧经皮后凸成形治疗骨质疏松性胸腰椎骨折
金成浩;蔡迎;钟杰林;苏啸天;靳小龙;
摘要(Abstract):
[目的]比较单侧与双侧经皮后凸椎体成形术(PKP)治疗老年骨质疏松性胸腰椎压缩性骨折的临床效果。[方法] 2015年1月~2019年4月本院收治的老年骨质疏松性胸腰椎压缩性骨折患者78例,根据手术入路不同分为单侧组、双侧组,均39例。比较两组临床效果。[结果]单侧组手术时间、X线照射次数、骨水泥注射量均显著少于双侧组(P<0.05)。随术后时间推移,两组VAS、QUALEFFO评分均显著降低(P<0.05);且双侧组术后3 d、6个月评分低于单侧组(P<0.05)。术后3 d、6个月两组椎体后凸Cobb角、椎体压缩率均相比术前依次降低(P<0.05);而组间三个时间点比较差异均无统计学意义(P>0.05)。[结论]两种PKP入路方式治疗效果相当,单侧入路可减少手术时间、X线照射次数及骨水泥注射量,而双侧入路对术后疼痛、生活质量的改善效果优于单侧入路。
关键词(KeyWords): 骨质疏松性胸腰椎压缩性骨折;经皮球囊扩张椎体后凸成形术;单侧入路;双侧入路
基金项目(Foundation):
作者(Author): 金成浩;蔡迎;钟杰林;苏啸天;靳小龙;
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DOI:
参考文献(References):
- [1]鲁俊东.经伤椎单侧与双侧行经皮椎体成形术技术治疗骨质疏松性椎体压缩骨折的疗效对比[J].颈腰痛杂志, 2017, 38(5):485-487.
- [2]皮海菊,肖淼生,尚晖.单侧椎弓根旁入路经皮椎体成形术治疗下胸椎压缩性骨折可行性、安全性和有效性分析[J].中国临床研究, 2017, 30(3):323-326.
- [3]胥少汀,葛宝丰,徐印坎.实用骨科学[M].第4版.北京:人民军医出版社, 2012:415-447.
- [4] Chen C, Li D, Wang Z, et al. Safety and efficacy studies of vertebroplasty, kyphoplasty, and mesh-container-plasty for the treatment of vertebral compression fractures:preliminary report[J]. Plos One, 2016, 11(3):e0151492.
- [5]陈伟,黄明光,殷海东,等.单侧经椎体侧方后上角穿刺入路在经皮穿刺椎体成形术中的应用[J].中国现代医学杂志, 2017,27(24):91-95.
- [6] Yang EZ, Xu JG, Huang GZ, et al. Percutaneous vertebroplasty versus conservative treatment in aged patients with acute osteoporotic vertebral compression fractures:a prospective randomized controlled clinical study[J]. Spine, 2016, 41(8):653-660.
- [7] Yang S, Chen C, Wang H, et al. A systematic review of unilateral versus bilateral percutaneous vertebroplasty/percutaneous kyphoplasty for osteoporotic vertebral compression fractures[J]. Acta Orthop Et Traumatologica Turcica, 2017, 51(4):290-297.
- [8]卢昌怀,刘志军,张宏波,等.单侧与双侧PVP治疗骨质疏松性胸腰椎压缩性骨折疗效分析[J].中国中医骨伤科杂志, 2015,23(4):23-25.
- [9]顾红林,张烽,周敦,等.双侧入路经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的并发症分析[J].江苏医药, 2017, 43(14):1039-1041.
- [10]薛威.单侧与双侧经皮穿刺椎体成形术治疗骨质疏松性胸腰椎压缩性骨折疗效比较[J].新乡医学院学报, 2017, 34(1):69-71.
- [11] Liang L, Chen X, Jiang W, et al. Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture?An updated systematic review and meta-analysis[J]. Ann Saudi Med, 2016, 36(3):165-174.
- [12]吴建伟,陈刚,李鹏飞.两种椎体强化术式治疗骨质疏松致腰椎骨折的临床疗效[J].江苏医药, 2017, 43(5):364-365.
- [13] Bae JW, Gwak HS, Kim S, et al. Percutaneous vertebroplasty for patients with metastatic compression fractures of the thoracolumbar spine:clinical and radiological factors affecting functional outcomes[J]. Spine J, 2016, 16(3):355-364.
- [14] El-Fiki M. Vertebroplasty kyphoplasty lordoplasty expandable devices and current treatment of painful osteoporotic vertebral fractures[J]. World Neurosurg, 2016, 91(1):628-632.