摘要
目的探讨采用单侧和双侧入路经皮穿刺椎体成形术治疗老年病理性脊柱骨折的的临床疗效。方法选取2016年1月~2018年12月西安交通大学第二附属医院骨三科收治并获得随访的老年病理性脊柱骨折患者38例,共46个椎体,作为研究对象。根据随机数字表法将其分为单侧入路经皮穿刺椎体成形术组(以下简称"单侧组"),双侧入路经皮穿刺椎体成形术组(以下简称"双侧组"),每组23例。观察并比较两组患者手术时间、骨水泥灌注量,记录并比较术前、术后第1天、术后第2天,以及术后6个月随访的视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)情况。对患者的疗效进行综合评估。结果单侧组手术时间及骨水泥注入量明显少于双侧组,差异高度有统计学意义(P<0.01);两组患者时间、交互作用比较,差异有高度统计学意义(P<0.01),提示两组患者术后疗效显著,且随着时间的延长,疗效也逐渐增加,两组患者组间交互作用比较,差异无统计学意义(P>0.05),提示两组间疗效无明显差别。进一步两两比较,两组术后1 d、2d、6个月均低于术前,术后2 d、6个月低于术后1 d,术后6个月低于术后2 d,差异均有高度统计学意义(P<0.01);两组各时间点组间比较差异无统计学意义(P> 0.05)。结论单侧椎弓根入路PVP术具有手术时间更短、受到辐射损害更小、骨水泥注射量小、治疗费用更低等优点,但远期看来,单侧和双侧PVP术在治疗病理性椎体压缩骨折方面都有显著的疗效。
Objective To investigate the clinical effect of unilateral and bilateral approach percutaneous vertebroplasty(PVP) in the treatment of senile pathological spinal fractures.Methods A total of 46 vertebral bodies of 38 patients with senile spinal fractures admitted to the Third department of Orthopedics,the Second Affiliated Hospital of Xi’an Jiao tong University from January 2016 to December 2018 and followed up were selected as subjects.According to the random number table method,they were divided into the unilateral approach percutaneous vertebroplasty group(hereinafter referred to as "unilateral group") and the bilateral approach percutaneous vertebroplasty group(hereinafter referred to as the " bilateral group"),with 23 cases in each group.The operation time and bone cement perfusion volume of the two groups were observed and compared,and the visual analogue score(VAS) and Oswestry dysfunction index(ODI) were recorded and compared before surgery,on the first and second day after surgery,and at the follow-up 6 months after surgery.The efficacy of the patients was evaluated comprehensively.Results The operation time and bone cement injection amount of the unilateral group were significantly less than that of the bilateral group,with highly statistically significant difference(P <0.01).The difference in time and interaction between the two groups was highly statistically significant(P <0.01),suggesting that the postoperative efficacy of the two groups was significant,and the efficacy increased gradually with the extension of time.There was no statistically significant difference in interaction between the two groups(P> 0.05),suggesting that there was no significant difference in efficacy between the two groups.Further pairwise comparison showed that 1 d,2 d and 6 months after surgery were lower than before surgery,2 d and 6 months after surgery were lower than 1 d and 6 months after surgery were lower than 2 d after surgery,and the differences were highly statistically significant P <0.01).There was no significant difference in interaction between the two groups at each time point(P> 0.05).Conclusion Unilateral pedicle approach PVP has the advantages of shorter operation time,less radiation damage,less injection of bone cement,and lower treatment cost.However,in the long run,unilateral and bilateral PVP have significant efficacy in the treatment of pathological vertebral compression fractures.
作者
樊李瀛
薛建利
程斌
张纯
吴昊
董军
FAN Liying;XUE Jianli;CHENG Bin;ZHANG Chun;WU Hao;DONG Jun(The Third Department of Orthopedics,the Second Affiliated Hospital of Xi′an Jiao Tong University,Shaanxi Province,Xi′an,710000,China)
出处
《中国医药导报》
CAS
2020年第6期81-84,共4页
China Medical Herald
基金
国家自然科学基金资助项目（81571209）
陕西省重点研发计划一般项目（2018SF-178）
