单侧与双侧经椎弓根入路椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的疗效比较

目的对比经单侧椎弓根入路与双侧椎弓根入路行椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的疗效。方法 47例骨质疏松性椎体压缩性骨折患者,其中23例采用单侧椎弓根入路,另24例采用双侧椎弓根入路,记录和比较两组患者手术时间、骨水泥注入量、住院时间,术前、术后一周、末次随访时的视觉模拟疼痛程度(VAS)评分,Oswestry功能障碍指数(ODI)评分。在患者术前、术后一周内及随访期间拍摄伤椎正侧位片或CT,了解椎体前缘高度和Cobb角的变化。结果单侧椎弓根入路组手术时间明显短于双侧组,骨水泥注入量少于双侧组,住院时间两者并无差异,两组患者术后较术前疼痛均得到明显缓解,功能及椎体高度、后凸畸形均得到恢复,两组间比较差异无统计学意义。结论经单侧椎弓根入路与双侧椎弓根入路行椎体后凸成形术的临床疗效无明显差别,但单侧椎弓根入路具有手术时间短、术中放射线投照次数少的优势。

Comparison about the therapeutic effect of kyphoplasty via unilateral and bilateral pedicle approach to treat the patients with osteoporotic vertebral compression fractures

Objective To compare the therapeutic effect of kyphoplasty via unilateral and bilateral pedicle approach to treat the patients with Osteoporotic vertebral compression fractures. Methods 47 of patients with Osteoporotic vertebral compression fractures,23 cases underwent kyphoplasty via unilateral pedicle approach,and the other 24 cases via bilateral pedicle approach. Operative time,amount of bone cement injecting,hospitalization time,and changes of the visual analog pain（ VAS） score,Oswestry Disability Index（ ODI） score,vertebral height,and Cobb angle in vertebral radiographs or CT preoperative,one week after operation and last follow-up were recorded and compared between the two groups.Results Operative time via unilateral pedicle approach was significantly shorter than that via bilateral pedicle approach,bone cement injected less than the bilateral group; but there was no difference in the times of hospitalization. Preoperative pain had been significantly alleviated,function and vertebral body height,kyphosis had both been restored in both group after operation,but there was no significant difference in all these changes between the two groups. Conclusion There is no significant difference in clinical efficacy between kyphoplasty via unilateral and bilateral pedicle approach,but via unilateral pedicle approach has shorter operative time,less intraoperative radiation projection.