单侧椎弓根入路小剂量骨水泥注射治疗骨质疏松性椎体压缩骨折的临床研究

目的 探讨单侧椎弓根入路小剂量骨水泥注射椎体成形术治疗骨质疏松性椎体压缩骨折的特点和临床疗效。方法 回顾分析2012-06-2013-11我院治疗的192个骨质疏松性椎体压缩骨折患者（共242个椎体）的临床资料,术中均采用单侧椎弓根入路小剂量骨水泥（1.25 ml-5 ml）注射椎体成形术,术中观察穿刺针针尖达到椎体中线的比率、手术时间、出血量、骨水泥灌注量、骨水泥向椎体外渗漏率,比较术前、术后1天及治疗后1周、1个月、6个月、12个月的VAS评分、椎体高度、功能障碍指数（ODI）的改善率。结果 192例（242个椎体）均经单侧椎弓根入路完成PVP操作,骨水泥在椎体内分布均匀对称,无穿刺并发症。术前与术后VAS评分、椎体高度及功能障碍指数差异均有统计学意义（P〈0.05）,疼痛和功能均得到了明显改善。结论 单侧椎弓根入路小剂量骨水泥注射椎体成形术治疗骨质疏松性椎体压缩骨折是一种安全、可行和有效的治疗方案,可以临床推广。

The clinical research for osteoporotic vertebral compression fractures via unilateral pedicle of vertebral arch approach with small priming volume of bone cement

Objective To explore the characteristics and effects of percutaneous vertebroplasty（PVP） for osteoporotic vertebral compression fractures（OVCFs） via unilateral pedicle of vertebral arch approach with small priming volume of bone cement. Methods Clinical data of 192 cases（242 vertebrae） with OVCFs admitted from June 2012 to（May） 2013 were analyzed retrospectively. All patients were performed the PVP via unilateral pedicle of vertebral arch approach with priming volume of bone cement 1.25 ml-5 ml. Puncture needle tip to vertebral median line,operative time,blood loss,priming volume of bone cement and cement leakage rate were observed. Visual analogue scales（VAS）,vertebral height and oswestry disability index（ODI） of preoperation,one day after operation,one week,one month,6 months and 12 months after treatment were compared.Results A total of 192 patients（242 vertebrae） were performed the PVP via unilateral pedicle of vertebral arch approach. Bone cement was evenly and symmetrically distributed in the vertebrae,and no complication of puncture was found. There were statistically significant differences in VAS score,vertebral height and ODI between pre-operation and post-operation（P〈0.05）. Pain and function were significantly improved. Conclusion The procedure of PVP via unilateral pedicle of vertebral arch approach with small priming volume of bone cement is a safe,feasible and effective surgical interference for OVCFs and can be promoted in clinical.