高龄骨质疏松性椎体压缩性骨折患者PVP手术简化操作的特点及疗效

目的探讨骨质疏松性椎体压缩性骨折患者单侧经皮穿刺椎体成形术术中不同穿刺方法的特点及其临床疗效。方法选取本院收治的50例骨质疏松性单个椎体压缩性骨折高龄女性患者，随机分成AB两组，其中PVP术中A组患者采用偏侧穿刺（正位X线照片穿刺针尖约位于穿刺侧椎弓根眼内侧皮质与棘突中线中心），B组采用中心穿刺（穿刺针尖位于棘突中线），所有患者术前视觉模拟疼痛评分（VAS）、术中手术时间、穿刺方法对比、及术后及随访疗效VAS评分。结果平均手术时间A组：26±5min，B组：38±7min，统计学分析有差异性（P〈0．05）；骨水泥渗漏率A组8％，B组：16％，统计学分析有差异性（P〈0．05）；术前、术后24h、术后6月AB两组VAS评分及随访结束VAS评分改善值统计学分析没有明显差异性（P〉0．05）。结论简化单侧经皮穿刺椎体成形术术中穿刺定位方法能减少手术时间，避免更多X线照射，手术操作简单，更安全、疗效肯定，更适合基层医院开展运用。

The characteristic and clinical effect of simplified operation in PVP for treatment of osteoporotic vertebral compression fractures

Objective To investigate the characteristic and clinical effect of different puncture methods in unilateral PVP for treatment of osteoporotic vertebral compression fractures （VCFs）. Methods 50 female patients with single VCFs were randomly divided into 2 groups （ A and B）. The characteristic of PVP puncture method in A group is that when the tip come to the position of maenaka third of the vertebral body,it is located in the middle of the medial cortex of the pedicle and the midline of the spinous process in posteroanterior radiograph （lateral puncture） ,but in B group the midline of the spinous process（ central puncture）. To compare the operation time, puncture methods and the VAS score of preoperation, postoperation and the last follow-up in A and B groups. Results The mean operation time in A group is 26 ± 5 min and in B group is 38± 7min （ P 〈 0. 05 ）. The leakage rate of bone cement in A group is 8% and in B group is16% （ P 〈0. 05 ）. The VAS score of preoperation,24 hours and 6 month postoperation and the VAS score improved value in the last follow-up in A and B groups are also statistical difference （ P 〈 0. 05 ）. Conclusion The simplified operation in unilateral PVP for treatment of osteoporotic vertebral compression fractures can reduce the operation time and avoid more x-irradiation. This operative procedure is more simple and safety and also have good clinical effect which more easy to develop in primary hospital.