单侧入路胸椎椎体成形术治疗胸椎骨折

目的：探索安全实施胸椎椎体成形术的方法。方法：采用经皮椎体成形术（PVP）治疗骨质疏松性胸椎骨折283例。将全部胸椎骨折分为三段：上段（T1~T4）、中段（T5~T8）、下段（T9~T12）,其中中段胸椎骨折77例,下段胸椎骨折206例,无上段胸椎骨折术病例。患者全部行伤椎CT扫描,根据伤椎CT扫描图像选择和测量标定穿刺路径,穿刺路径采用经左侧椎弓根或经左肋颈与椎弓根之间间隙进针,应用椎体成形穿刺导向器导引穿刺实施PVP,并观察各段胸椎骨折疗效及并发症。结果：平均随访1 2个月,中段胸椎骨折7 7例中：疼痛完全缓解（CR）7 4例,CR率为96.10%;部分缓解（PR）3例,PR率3.40%,有效率100.00%（有效率=CR率＋PR率）。下段胸椎骨折206例中：CR185例,CR率89.81%;PR 21例,PR率10.19%,有效率100.00%。4例术后出现胸背疼痛,2周后症状消失。结论：PVP治疗胸椎骨折是一种安全有效的方法。

The applicationg of unilateral piercing percutaneous verebroplasty for vertebral body fractures in thoracic vertebra

Objective：To explore the safe method for vertebral body fractures in thoracic vertebra by percutaneous vertebroplasty.Methods：Two hundreds and eighty-three cases with vertebral body fractures in thoracic vertebra were treated by unilateral pierceing.The thoracic vertebra is divided into three sections：epimere fracture（T1～T4）,middle piece fracture（T5～T8）,hypomere fracture（T9～T（12））,77 cases were middle piece fracture,206 cases were hypomere fracture,no cases were epimere fracture.The former were done CT scan,according to the images of CT scan,to choice and measure nominal puncture way.The puncture way with penetrate through pediculus arcus vertebrae or gaps between pediculus arcus vertebrale and collum costae.To done vertebroplasty by the centrum forming director.To observed the effect and complication.Results：Followed up for 12 months,74 of 77 cases with middle piece fracture were complete remission（CR）,3 cases were partial remission,CR rate was 96.10%,PR rate was 3.90%,the total effective rate was 100.00%（Effective rate=CR rate＋PR rate）.185 of 206 cases with hypomere fracture were CR,21 cases were PR,CR rate was 89.81%,PR rate was 10.19%,the total effective rate was 100.00%.4 cases with backache were recovered after 2 weeks.Conclusion：PVP is a efficacious and safe methods for vertebral body fractures in thoracic vertebra.