初步分析安全型单侧椎体成形术时放置弹性引导针到对侧的可行性

目的通过椎体CT测量、模型实验和临床实验,初步分析经椎弓根单侧操作,预弯弹性引导针达到椎体对侧的可行性。方法对110例正常腰段和胸腰段椎体(T_(10)-L_5)进行水平位CT测量,了解弹性引导针达到对侧需要的预弯弧度和弧形长度,模型操作成功后,对45例骨质疏松性压缩骨折椎体进行术中实际操作,透视观察,进行影像学资料收集及分析。结果腰段和胸腰段脊柱压缩骨折,单侧椎弓根放置弹性引导针,需要弧度35°±5.6°,长度4 cm±1.1 cm,可以达到椎体对侧,完成单侧椎弓根穿刺后放置球囊到对侧的初始步骤。结论经单侧椎弓根穿刺,放置预弯弹性引导针到椎体对侧是确实安全可行的。是《安全性单侧椎体成形系统研发》课题中的最重要步骤,手术所需要特定的扩张器械和球囊尚在进一步完善中。

To analyze the feasibility of putting the guide wire to other side of the vertebral in cause of the safe unilateral kyphoplasty

Objective To discuss the feasibility of puncturing from one side of the pedicle of vertebral to opposite side in percutaneous kyphoplasty (PKP). Methods To measure the length and radian of the preflex guide wire in the vertebral on the 110 cases of CT scan. After operation to the models of the vertebral, 45 patients with spinal compression were selected to cure with percutaneous kyphoplasty via the safe unilateral kyphoplasty. Results In the safe unilateral kyphoplasty, the length of the guide wire is 4 cm ± 1.1 cm, the radian of the guide wire is 35°±5.6°. According to the data, we can successfully carry out the operation to the models and patients. Conclusion Puncturing from one side of the pedicle of vertebral to opposite side in percutaneous kyphoplasty is feasible and safe with preflex guide wire. This is the most important step in the operation of the unilateral PKP by single side of the pedicles. The operation required specific dilatation instruments and balloon need to be further perfected.