单双入路后凸成形术治疗胸腰椎压缩骨折比较

目的：探讨单入路与双入路球囊扩张椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折在疗效和安全性上的差异。方法：52例患者随机分为单入路组和双入路组。单入路组16例,经皮伤椎单侧入路穿刺建立工作通道,放置单枚球囊于伤椎内,行球囊扩张椎体后凸成形术 双入路组36例,经皮伤椎双侧入路穿刺建立工作通道,在双侧分别放置球囊于伤椎内,行球囊扩张椎体后凸成形术。结果：52例患者均未发现神经损伤等并发症,两组背痛缓解程度、脊柱后凸畸形矫正度、伤椎前缘高度恢复比较,差异无显著性（P〉0.05） 两组手术时间和透视次数比较,差异有显著性（P〈0.05）。结论：单入路与双入路椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折疗效相似,单入路较双入路能明显减少手术时间和放射暴露。

Contrast Study between Unilateral and Bilateral Percutaneous Balloon Kyphoplasty for Qsteoporotic Thoracolumbar Compression Fractures

Objective To contrast unilateral and bilateral percutaneous balloon kyphoplasty for osteoporotie thora- columbar compression fractures. Methods Fifty two consecutive procedures were performed in 52 patients of osteo- porotic thoracolumbar fracture under local anesthesia. A group involved unilateral percutaneous insertion of on inflatable bone tamps into the anterior - center part of fractured vertebral body under fluoroscopic guidance, B group involved bilat- eral percutaneous insertion of one inflatable bone tamps into the anterior- center part of fractured vertebral body under fluoroscopic guidance. Inflation of the bone tamp would elevate the endplates, restoring the vertebral body back toward its original height, while creating a cavity to be filled with bone cement. Tile operative time and frequency of X - ray＂ imaging were documented. The radiographic findings and back pain in A Group were compared with those in B group. Results Both groups tolerated the procedure well with immediate relief of their back pain in 24 hours. The patients were al- lowed to take walk next day after the procedure. Complications such as epidural cement leakage or neural damage were not demonstrated in the study. The mean operative time and average number of fluoroscopy in A group were significantly less than those in B group （ P 〈 0.05）. There was no significant differences between the two groups in the kyphosis correction and pain relief （ P 〉 0.05）. Conclusion Unilateral percutaneous balloon kyphoplasty has similar clinic result com- pared with bilateral percutaneous balloon kyphoplasty for osteoporotic thoracolumbar compression fractures. The number of fluoroscopy and the amount of X - ray radiation kyphoplasty in unilateral percutaneous balloon decrease significantly.