单入路后凸成形术治疗老年胸腰椎压缩性骨折

目的评价单入路与双入路椎体后凸成形术治疗老年胸腰椎压缩性骨折的临床效果和安全性。方法对老年胸腰椎压缩性骨折患者43例随机分为单入路组和双入路组。单入路组21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22例，经皮伤椎双侧入路穿刺建立工作通道，双侧分别放置球囊于伤椎内，行球囊扩张椎体后凸成形术。分别记录两组手术时间、透视次数、术后患者背痛缓解程度、术前术后伤椎高度和脊柱后凸畸形Cobb角。结果43例患者治疗效果包括背痛缓解程度、伤椎前缘高度恢复、脊柱后凸畸形矫正度比较无统计学意义（P〉0．05）；两组均元神经损伤等并发症；两组手术时间和透视次数比较，有统计学意义（P〈0．01）。结论单入路与双入路椎体后凸成形术治疗老年胸腰椎压缩性骨折疗效无差别，但单入路较双入路能显著减少手术时间和射线暴露。

Comparison between Unilateral and Bilateral Percutaneous Balloon Kyphoplasty for Thoracolumbar Compression Fractures in the Elderly

Objective To compare unilateral and bilateral pereutaneous balloon kyphoplasty for osteoporotic thoracolumbar compression fractures in the elderly.Methods Consecutive procedures were performed in 43 patients of oateoporotic thoracolumbar fracture under local anesthesia.A group(21 cases)involved unilateral percutaneous insertion of one inflatable bone tamp into the anterior-center part of fractured vertebral body under fluoroscopic guidance,while B group(22 cases)involved bilateral percutaneous insertion of two inflatable bone tamps.Inflation of the hone tamp would elevate the endplates,restoring the vertebral body back toward its original height,while creating a cavity to be filled with bone cement.The operation time and frequency of X-ray imaging were documented.The radiographic findings and back pain were compared between two groups.Results There was no significant differences between the two groups in the kyphosis correction and pain relief( P > 0. 05 ). Complications such as epidural cement leakage or neural damage were not demonstrated in the study. The mean operation time and average number of fluoroscopy in A group were significantly less than those in B group (P <0. 01 ). Conclusion Unilateral percutaneous balloon kyphoplasty has similar clinical result compared with bilateral percutaneous balloon kyphoplasty for elderly thoracolumbar compression fractures. The number of fluoroscopy and the amount of X-ray radiation kyphoplasty in unilateral percutaneous balloon decrease significantly.