经椎弓根中下1/3进针治疗重度椎体压缩性骨折

目的讨论椎体成形术（PVP）经椎弓根中下1/3进针在治疗重度骨质疏松性椎体压缩性骨折时的可行性及技术优势,总结手术经验。方法 2009年1月～2011年6月采用椎体中下1/3进针PVP治疗重度骨质疏松性椎体压缩骨折18例,共21个伤椎。术前依据X线片、CT、MRI设计进针通道,术中在C型臂透视下完成穿刺。结果 18例手术均完成,穿刺针针尖均到达椎体前1/3。疼痛于术后明显缓解,VAS评分由术前（8.3±0.9）分到术后3 d（2.7±0.5）分（P〈0.01）;3例3个椎体发生骨水泥泄漏。结论在椎体成形术治疗重度骨质疏松性椎体压缩性骨折时经椎弓根中下1/3进针具有可行性、安全性及较大优势。

Treatment of severe vertebral compression fracture by inserting needle through the lower 1/3 of vertebral pedicle

Objective To discuss the feasibility and technical advantages of the vertebroplasty inserting needle polyvinylpyrrolidone(PVP) through the lower 1/3 of vertebral pedicle in the treatment of severe vertebral compression fracture,and summarize the surgical experience.Methods From January 2009 to June 2011,18 patients with severe osteoporotic vertebral compression fracture with a total of 21 injured vertebrae were treated with PVP inserting needle through the lower 1/3 of vertebral pedicle.Before the surgery,the needle channel was designed according to the X ray,CT and MRI.During the surgery,the puncture was completed under C-arm fluoroscopy.Results The 18 surgeries were all completed,and all the puncture needle tips reached the anterior 1/3 of the vertebrae.Pain relieved significantly after the surgery and he VAS score decreased from(8.3±0.9) points before the surgery to(2.7±0.5) points after the surgery(P < 0.01);PVP occurred in three patients with a total of 3 vertebrae.Conclusion The vertebroplasty inserting needle through the lower 1/3 of vertebral pedicle in the treatment of severe osteoporotic vertebral compression fracture is feasible,safe and advantageous.