双侧双平面与单侧经椎弓根椎体成形术疗效比较

目的]比较双侧双平面与单侧经椎弓根椎体成形术治疗骨质疏松性椎体压缩性骨折的疗效.方法]2005年10月～2009年6月,60例(71节)骨质疏松性椎体压缩性骨折患者,在C型臂X线机或(和)CT引导下,双侧双平面或单侧经椎弓根向病椎内穿针并注入骨水泥聚甲基丙烯酸甲酯(polymethylmethacrylate,PMMA).术后X线片和CT观察骨水泥的分布和渗漏情况,采用椎体高度恢复率、椎体后凸Cobb角、VAS评分及ODI指数进行手术疗效比较,并观察有无并发症发生.结果]71节60例骨质疏松性椎体压缩性骨折中,36节椎体行双侧双平面经椎弓根入路、35节行单侧经椎弓根人路经皮椎体成形术.术后1周、1年时,两组椎体高度恢复率、椎体后凸Cobb角、VAS评分及ODI指数较术前均有改善(P＜0.05).术后1周双侧双平面组与单侧组比较,椎体高度恢复率、椎体后凸Cobb角、VAS评分有显著性差异(P＜0.05),ODI指数及并发症发生率无显著性差异(P＞0.05).而术后1年时,VAS评分无显著性差异(P＞0.05).结论]不同入路经椎弓根椎体成形术中,椎体高度恢复率、椎体后凸Cobb角、早期VAS评分的改善在双侧双平面组优于单侧组;并发症发生率、ODI指数、中远期VAS评分两组疗效相近.

Comparison of clinical effect between bipedicular dual planes and unipedicular approach to percutaneous vertebroplasty

Objective]To compare the clinical efficacy of bipedicular dual planes with unipedicular approach to percutaneous vertebroplasty in treatment of osteoporotic vertebral compressive fracture.Method]A retrospective study was performed on 71 osteoporotic vertebral compressive fractures of 60 patients from October 2005 to June 2009,which were treated by percutaneous vertebroplasty(PVP) via a bipedicular dual planes or unipedicular approach to inject polymethylmethacrylate(PMMA) cement monitored by C-arm fluoros...