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单侧穿刺椎体后凸成形术骨水泥分布与穿刺角度的关系

摘要点击次数: 2153 全文下载次数: 1260 投稿时间：2014-09-18

作者	Author	单位	Address	E-Mail
王想福	WANG Xiang-fu	甘肃省中医院骨科, 甘肃兰州 730050	Department of Orthopaedics, Traditional Chinese Medical Hospital of Gansu Province, Lanzhou 730300, Gansu, China
范有福	FAN You-fu	甘肃省中医院骨科, 甘肃兰州 730050	Department of Orthopaedics, Traditional Chinese Medical Hospital of Gansu Province, Lanzhou 730300, Gansu, China	hifan@sina.Com
石瑞芳	SHI Rui-fang	甘肃省中医院骨科, 甘肃兰州 730050	Department of Orthopaedics, Traditional Chinese Medical Hospital of Gansu Province, Lanzhou 730300, Gansu, China
邓强	DENG Qiang	甘肃省中医院骨科, 甘肃兰州 730050	Department of Orthopaedics, Traditional Chinese Medical Hospital of Gansu Province, Lanzhou 730300, Gansu, China
李中锋	LI Zhong-feng	甘肃省中医院骨科, 甘肃兰州 730050	Department of Orthopaedics, Traditional Chinese Medical Hospital of Gansu Province, Lanzhou 730300, Gansu, China

期刊信息：《中国骨伤》2015年，第28卷，第8期，第704-707页

DOI：10.3969/j.issn.1003-0034.2015.08.006

基金项目:卫生部医药卫生科技发展研究中心专项科研课题(编号:W2014ZT210)

中文摘要:

目的:探讨胸腰椎压缩骨折单侧穿刺椎体后凸成形术椎体内骨水泥理想分布与穿刺角度的关系。

方法:对2013年1月至2014年3月收治的37例(37椎)胸腰椎骨质疏松性压缩骨折患者临床资料进行回顾性分析,其中男6例,年龄65～78岁,平均(71.83±6.15)岁;女31例,年龄57～89岁,平均(71.06±7.89)岁。37例患者均行单侧穿刺椎体后凸成形术。术前对影像学资料进行分析,并测量病椎穿刺角度、穿刺点,术中参考术前测量数据进行穿刺,术后对X线片骨水泥分布面积进行计算,分析经皮单侧穿刺在合适的穿刺角度下骨水泥的双侧分布效果,并按照VAS评分对疗效进行评定。

结果:胸椎T₈-T₁₂穿刺角度28°～33°,平均30.4°;腰椎L₁-L₅穿刺角度28°～35°,平均31.3°。术后复查X线片正位片双侧骨水泥面积比值为0.97±0.15,双侧弥散面积基本均等,总体趋势为穿刺测面积略大于对侧面积。患者术后VAS评分较术前有显着降低,术后疼痛明显缓解。

结论:行单侧穿刺时,掌握适当外展角,使椎体内骨水泥分布达到双侧穿刺效果。通过术前对影像学资料进行分析,确定穿刺角度及进针点,术中参考术前测量数据进行穿刺,单侧穿刺椎体内骨水泥的分布即可达到双侧穿刺分布效果。

【关键词】骨质疏松椎体压缩骨折经皮椎体后凸成形术骨水泥分布穿刺角度

The relationship between angle of puncture and distribution of bone cement of unilateral percutaneous kyphoplasty for the treatment of thoracolumbar compression fractures

ABSTRACT

Objective:To explore the relationship of bone cement distribution and the puncture angle in the treatment of thoracolumbar compression fractures with unilateral percutaneous kyphoplasty(PKP).

Methods:The clinical data of 37 patients with thoracolumbar osteoporotic compression fractures underwent PKP between January 2013 to March 2014 were retrospectively analyzed,all punctures were performed unilaterally. There were 6 males,aged from 65 to 78 years old with an average of (71.83±6.15) years;and 31 females,aged from 57 to 89 years old with an average of (71.06±7.89) years. Imaging data were analyzed and puncture angle and puncture point were measured before operation. According to the measured data,the puncture were performeds during the operation. Distribution area of bone cement were calculated by X-rays data after operation. The effect of bone cement distribution on suitable puncture angle was analyzed;VAS score was used to evaluate the clinical effects.

Results:The puncture angle of thoracic vertebrae in T₈-T₁₂ was from 28 ° to 33 ° with an average 30.4 °;and the puncture angle of lumbar vertebrae in L₁-L₅ was from 28 ° to 35 ° with an average of 31.3 °。 Postoperative X-rays showed the area ratios of bilateral bone cement was 0.97±0.15. Bilateral diffuse area were basic equal. Postoperative VAS score decreased significantly(1.89±1.29 vs 7.03±1.42).

Conclusion:Through measure imaging data before operation with PKP,the puncture point and entry point can be confirmed. According the measured data to puncture during operation,unilateral puncture can reach the distribution effect of the bilateral puncture in the treatment of thoracolumbar compression fractures.

KEY WORDS Osteoporosis Vertebral compression fractures Percutaneous kyphoplasty Bone cement distribution Puncture angle

引用本文，请按以下格式著录参考文献：

中文格式:	王想福,范有福,石瑞芳,邓强,李中锋.单侧穿刺椎体后凸成形术骨水泥分布与穿刺角度的关系[J].中国骨伤,2015,28(8):704~707
英文格式:	WANG Xiang-fu,FAN You-fu,SHI Rui-fang,DENG Qiang,LI Zhong-feng.The relationship between angle of puncture and distribution of bone cement of unilateral percutaneous kyphoplasty for the treatment of thoracolumbar compression fractures[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(8):704~707

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