新型G型臂X线机下行双侧经皮椎体后凸成形术的疗效

目的探讨新型G型臂x线机下行双侧经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）对骨质疏松性椎体压缩骨折的疗效。方法回顾性分析行PKP治疗的骨质疏松性椎体压缩骨折患者118例（193个椎体）的临床数据，按普通C型臂x线机下经单侧椎弓根途径行PKP和新型G型臂x线机下经双侧椎弓根途径行PKP分为2组。普通x线机组68例121个椎体，新型x线机组50例72个椎体，比较2组患者手术时间、骨水泥注入量、手术前后疼痛视觉模拟评分（visual analogue scale，VAS）、椎体平均高度、局部Cobb角改善及常见并发症的发生情况。结果普通x线机组1例患者因不能耐受，终止手术，余117例患者顺利完成手术。普通X线机组手术时间（55±12）min，新型x线机组手术时间（53±14）min，2组间比较差异无统计学意义（P〉0．05）；2组术后1年时VAS较治疗前明显改善（P〈0．05），组间比较差异无统计学意义（P〉0．05）；2组手术后椎体平均高度及局部Cobb角改变较治疗前明显改善（P〈0．05），组间比较差异有统计学意义（P〈0．05）；普通x线机组椎体再骨折发生率为23．5％，新型x线机组为6．0％，2组比较差异有统计学意义（P〈0．05）。结论新型G型臂x线机下行双侧PKP和普通x线机下行单侧PKP对骨质疏松性椎体压缩骨折临床效果同样满意，单侧穿刺时间优势不再明显，而前者具有椎体平均高度恢复及局部Cobb角改变良、椎体再骨折的发生率低及X线暴露量少等优点。

OUTCOMES OF BILATERAL PERCUTANEOUS KYPHOPLASTY FOR OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURE WITH NEW G-ARM X-RAY MACHINE

Objective To Explore the clinical outcomes of bilateral kyphoplasty forosteoporotic compression fracture with the new G-arm X-ray machine. Methods 118 cases （ 193 vertebrae ） who sustained osteoporotic vertebral compression fracture and underwent pereutaneous kyphoplasty were reviewed retrospectively. All cases were divided into two groups according to unilateral with common C- arm X-ray machine or bilateral with the new G-arm X-ray machine approach. The common group （68 patients, 121 vertebrae） while the new X-ray group （50 patients,72 vertebrae ）. The operation time, the amount of bone cement and the visual analogue scale （ VAS ）, vertebral body height, Cobb angle at pre and post-operation and incidence of complications were used to observe the difference between two groups. Results All but one patient underwent surgery successfully. The common group had an average operative time of （55 ± 12）min while the new X-ray group （53 ± 14） min. There was no significant difference in the operation time between two groups （ P 〉 0.05 ）. The VAS score decreased significantly after operation （P 〈0.05）,but no significant difference was noted between two groups （ P 〉0. 05 ）, while the rate of adjacent vertebral fractures had significant difference （P 〈 0. 05 ）. Conclusion Both unilateral or bilateral kyphoplasty are reliable for osteoporotic vertebral compression fractures, but the bilateral kyphoplasty has the advantage of better recovery for average vertebral height and local Cobb angle and lower adjacent vertebral fractures rate.