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对侧补充穿刺在单侧经皮椎体成形术骨水泥弥散不佳中的应用
Hits: 1656   Download times: 1066   Received:May 03, 2018    
作者Author单位UnitE-Mail
邓晓强 DENG Xiao-qiang 广州中医药大学第二附属医院 广东省中医院骨科, 广东 广州 510120 Department of Orthopaedics, the Second Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China 12120834@qq.com 
吴永生 WU Yong-sheng 广州中医药大学, 广东 广州 510405  
王慧敏 WANG Hui-min 广州中医药大学第二附属医院 广东省中医院骨科, 广东 广州 510120 Department of Orthopaedics, the Second Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine, Guangzhou 510120, Guangdong, China  
期刊信息:《中国骨伤》2018年31卷,第12期,第1168-1171页
DOI:10.3969/j.issn.1003-0034.2018.12.019


目的:探讨单侧经皮穿刺椎体成形术(PVP)中骨水泥弥散不佳时,行对侧补充穿刺的临床价值。

方法:回顾2015年1月至2016年12月采用单侧穿刺PVP方法治疗285例(319椎)骨质疏松压缩性骨折(OVCF)患者中,骨水泥弥散不佳时行对侧补充穿刺的13例,男5例,女8例;年龄63~88岁;T11 1例,T12 4例,L1 3例,L2 2例,L3 1例,L5 2例;受伤至手术时间1~16 d。观察该组患者VAS评分、ODI评分、残余腰痛、椎体两侧高度丢失等情况。

结果:行对侧补充穿刺的13例术后VAS评分、ODI评分均较术前明显改善(P<0.01),且均未出现术后残余腰背痛。随访期间内椎体两侧高度丢失(原穿刺侧0.35~3.69 mm;补充穿刺侧0.59~3.66 mm)差异无统计学意义。

结论:对于单侧PVP出现骨水泥弥散不佳时,采取对侧补充穿刺能减少术后残余痛的发生,同时可减小椎体两侧高度丢失差值,继而防止患椎侧方畸形的发生,是一种安全可靠的方法及思路。
[关键词]:骨折,压缩性  骨质疏松性骨折  椎体成形术
 
Application of contralateral supplementary puncture in unilateral percutaneous vertebroplasty for poor bone cement dispersion
Abstract:

Objective: To evaluate the clinical value of contralateral supplementary puncture in unilateral percutaneous vertebroplasty(PVP) with poor cement dispersion.

Methods: From January 2015 to December 2016,PVP was performed unilaterally in 285 patients(319 vertebrae) with osteoporotic compression fractures(OVCF). Contralateral percutaneous puncture was performed in 13 patients with poor cement dispersion. Among the patients,5 cases were male and 8 patients were female,ranging in age from 63 to 88 years old;1 case of T11,4 cases of T12,3 cases of L1,2 cases of L2,1 case of L3,and 2 cases of L5. The time from injury to operation ranged from 1 to 16 days. The VAS score,ODI score,residual low back pain and loss of vertebral height were observed.

Results: The VAS score and ODI score of 13 patients who underwent contralateral supplementary puncture were significantly improved (P<0.01),and there was no postoperative residual low back pain. During the follow-up period,there was no significant difference in the height loss between the two sides of the vertebral body (0.35 to 3.69 mm on the original puncture side and 0.59 to 3.66 mm on the supplementary puncture side).

Conclusion: For unilateral PVP with poor cement dispersion,contralateral puncture can reduce the occurrence of postoperative residual pain; at the same time,can reduce the difference between the loss of height on both sides of the vertebral body,and then prevent the occurrence of lateral vertebral deformity,which is a safe and reliable method.
KEYWORDS:Fractures,compression  Osteoporotic fractures  Vertebroplasty
 
引用本文,请按以下格式著录参考文献:
中文格式:邓晓强,吴永生,王慧敏.对侧补充穿刺在单侧经皮椎体成形术骨水泥弥散不佳中的应用[J].中国骨伤,2018,31(12):1168~1171
英文格式:DENG Xiao-qiang,WU Yong-sheng,WANG Hui-min.Application of contralateral supplementary puncture in unilateral percutaneous vertebroplasty for poor bone cement dispersion[J].zhongguo gu shang / China J Orthop Trauma ,2018,31(12):1168~1171
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