双侧经椎弓根入路与单侧经椎弓根外极外侧入路在椎体成形术中的应用比较
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王兆红 WANG Zhao-hong 东南大学附属徐州市中心医院脊柱外科,江苏 徐州 221009 Department of Spinal Surgery, the Affiliated Hospital of South-East University, Xuzhou Central Hospital, Xuzhou 221009 Jiangsu, China wangzhaohong1976@sohu.com 
吴德慧 WU De-hui 东南大学附属徐州市中心医院脊柱外科,江苏 徐州 221009 Department of Spinal Surgery, the Affiliated Hospital of South-East University, Xuzhou Central Hospital, Xuzhou 221009 Jiangsu, China  
马超 MA Chao 东南大学附属徐州市中心医院脊柱外科,江苏 徐州 221009 Department of Spinal Surgery, the Affiliated Hospital of South-East University, Xuzhou Central Hospital, Xuzhou 221009 Jiangsu, China  
戴维享 DAI Wei-xiang 东南大学附属徐州市中心医院脊柱外科,江苏 徐州 221009 Department of Spinal Surgery, the Affiliated Hospital of South-East University, Xuzhou Central Hospital, Xuzhou 221009 Jiangsu, China  
吴继斌 WU Ji-bin 东南大学附属徐州市中心医院脊柱外科,江苏 徐州 221009 Department of Spinal Surgery, the Affiliated Hospital of South-East University, Xuzhou Central Hospital, Xuzhou 221009 Jiangsu, China  
赵猛 ZHAO Meng 东南大学附属徐州市中心医院脊柱外科,江苏 徐州 221009 Department of Spinal Surgery, the Affiliated Hospital of South-East University, Xuzhou Central Hospital, Xuzhou 221009 Jiangsu, China  
冯杰 FENG Jie 东南大学附属徐州市中心医院脊柱外科,江苏 徐州 221009 Department of Spinal Surgery, the Affiliated Hospital of South-East University, Xuzhou Central Hospital, Xuzhou 221009 Jiangsu, China  
韩猛 HAN Meng 东南大学附属徐州市中心医院脊柱外科,江苏 徐州 221009 Department of Spinal Surgery, the Affiliated Hospital of South-East University, Xuzhou Central Hospital, Xuzhou 221009 Jiangsu, China  
田银鹏 TIAN Yin-peng 东南大学附属徐州市中心医院脊柱外科,江苏 徐州 221009 Department of Spinal Surgery, the Affiliated Hospital of South-East University, Xuzhou Central Hospital, Xuzhou 221009 Jiangsu, China  
期刊信息:《中国骨伤》2012年,第25卷,第12期,第975-978页
DOI:10.3969/j.issn.1003-0034.2012.12.002
基金项目:
中文摘要:

目的:分析经双侧椎弓根穿刺和经单侧椎弓根外极外侧穿刺入路治疗骨质疏松症性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCFs)的优缺点。

方法:对2008年1月至2010年12月收治的54例骨质疏松症性椎体压缩骨折的临床资料进行回顾性分析,男24例,女30例;年龄59~88岁,平均66.9岁。其中采用双侧椎弓根入路者26例(双侧组),采用单侧椎弓根外极外侧穿刺入路者28例(单侧组),对两组入路的骨水泥注入量、术中放射投照次数、手术时间、骨水泥渗漏率、血管神经并发症等进行观察,通过VAS评分对两组患者临床疗效进行比较,通过影像学资料观察伤椎局部后凸Cobb角、椎体前缘压缩比率并评估畸形恢复情况。

结果:双侧组和单侧组的骨水泥注入量、术中放射投照次数、手术时间、VAS评分分别为(6.6±0.8) ml和(6.8±1.5) ml,(21.7±4.0)次和(17.9±3.6)次,(40.5±5.5) min和(31.6±9.1) min,(2.8±0.6)分和(3.1±0.5)分;影像学指标局部后凸Cobb角和椎体前缘压缩比率分别为(7.6±2.0)°和(6.9±2.6)°,(18.1±5.8)%和(16.5±6.1)%.两组均无血管神经并发症,骨水泥渗漏率双侧组3例(11%),单侧组3例(10%);两组在VAS评分、椎体高度恢复、Cobb角、骨水泥注入量、骨水泥渗漏率等方面比较差异无统计学意义,但在术中放射投照次数、手术时间方面差异有统计学意义(P<0.05).

结论:经双侧椎弓根入路和经单侧椎弓根外入路均能治疗骨质疏松性椎体压缩骨折,但经单侧椎弓根外穿刺途径可缩短手术时间,减少术中医源性放射线损伤。
【关键词】骨质疏松  脊柱骨折  外科手术
 
Comparison between bipedicular approach and uni-extrapedicular approach in application of vertebroplasty
ABSTRACT  

Objective:To analyze the advantages and disadvantages of bipedicular approach and uni-extrapedicular approach of vertebroplasty in treating osteoporotic vertebral compression fractures(OVCFs).

Methods:From January 2008 to December 2010,53 patients with OVCFs were retrospectively analyzed. There were 24 males,30 females with an average age of 66.9 years(ranged,59 to 88 years). Among them,26 cases were treated with bipedicular approach,28 cases were treated with uni-extrapedicular approach. The data of bone cement injection,radiology exposure times,operation time,bone cement leakage and vessels nerve complications were observed. Cobb angle,vertebral compression ration were observed by imaging data,and evaluate recovery of deformity.

Results:The data of bone cement injection,radiology exposure times,operation time,VAS score were (6.6±0.8) ml and (6.8±1.5) ml,(21.7±4.0) times and (17.9±3.6) times,(40.5±5.5) min and (31.6±9.1) min,(2.8±0.6) scores and (3.1±0.5) scores respectively. Cobb angle,vertebral compression ration were (7.6±2.0)°and (6.9±2.6)°,(18.1±5.8)% and (16.5±6.1)%. There were no vascular nerve complications occurred. For bone cement leakage,3 cases (11%) in bipedicular approach and 3 cases (11%) in uni-extrapedicular approach. There was no significant differences between two groups in VAS score,recovery of vetebral body,Cobb angle,bone cement injection and bone cement leakage,but had significant differences in radiology exposure times and operation time (P<0.05).

Conclusion:Both of two approaches can treat OVCFs well,especially extropedicle approach which could reduce operation time and radiation shoot frequency.
KEY WORDS  Osteoporosis  Spinal fractures  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:王兆红,吴德慧,马超,戴维享,吴继斌,赵猛,冯杰,韩猛,田银鹏.双侧经椎弓根入路与单侧经椎弓根外极外侧入路在椎体成形术中的应用比较[J].中国骨伤,2012,25(12):975~978
英文格式:WANG Zhao-hong,WU De-hui,MA Chao,DAI Wei-xiang,WU Ji-bin,ZHAO Meng,FENG Jie,HAN Meng,TIAN Yin-peng.Comparison between bipedicular approach and uni-extrapedicular approach in application of vertebroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(12):975~978
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