[1]杨磊,崔宏勋,饶耀剑,等.弯角穿刺椎体成形装置辅助下单侧穿刺经皮椎体成形术治疗骨质疏松性椎体压缩骨折[J].中医正骨,2020,32(01):64-68.
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弯角穿刺椎体成形装置辅助下单侧穿刺经皮椎体成形术治疗骨质疏松性椎体压缩骨折()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年01期
页码:
64-68
栏目:
临床报道
出版日期:
2020-01-20

文章信息/Info

作者:
杨磊; 崔宏勋; 饶耀剑; 周英杰; 杨生民
(河南省洛阳正骨医院/河南省骨科医院,河南 洛阳 471002)
关键词:
骨质疏松性骨折;  脊柱骨折;  椎体成形术;  弯角穿刺椎体成形装置
摘要:
目的:探讨弯角穿刺椎体成形装置辅助下单侧穿刺经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)的临床疗效与安全性。方法:2018年1月至2019年1月采用弯角穿刺椎体成形装置辅助下单侧穿刺PVP治疗OVCF患者30例。男12例,女18例。年龄52～83岁,中位数70岁。均为单个椎体骨折,T8骨折2例、T9骨折3例、T10骨折3例、T11骨折5例、T12骨折7例、L1骨折6例、L2骨折4例。骨密度T值-3.8～-2.6,中位数-3.2。记录手术时间、出血量及骨水泥注入量。采用视觉模拟量表(visual analogue scale,VAS)和Oswestry功能障碍指数(Oswestry disability index,ODI)评价临床疗效。观察骨水泥渗漏、神经损伤、伤椎塌陷以及再骨折等并发症的发生情况。结果:手术时间17～30 min,中位数23 min。术中出血量5～10 mL,中位数9 mL。骨水泥注入量3.5～6.8 mL,中位数4.6 mL。所有患者均获随访,随访时间3～12个月,中位数8个月。患者腰背部疼痛VAS评分,术前(7.57±1.33)分,术后24 h(2.73±1.01)分,术后3个月(2.60±0.72)分,术后6个月(1.73±0.74)分; ODI,术前(57.93±9.43)%,术后24 h(28.13±6.82)%,术后3个月(20.90±4.13)%,术后6个月(19.97±2.14)%。1例患者发生骨水泥渗漏,渗漏位于椎体前方,未出现神经损伤症状,故未予处理。至末次随访时,均未发生感染、神经损伤、伤椎塌陷及再骨折。结论:弯角穿刺椎体成形装置辅助下单侧穿刺PVP治疗OVCF,疗效确切,骨水泥渗漏、伤椎塌陷及再骨折等并发症少。

参考文献/References:

[1] WATTS N B,HARRIS S T,GENANT H K.Treatment of painful osteoporotic vertebral fractures with percutaneous vertebroplasty or kyphoplasty[J].Osteoporos Int,2001,12(6):429-437.
[2] MARTIKOS K,GREGGI T,FALDINI C,et al.Osteoporotic thoracolumbar compression fractures:long-term retrospective comparison between vertebroplasty and conservative treatment[J].Eur Spine J,2018,27(Suppl 2):244-247.
[3] 顾力军,董福慧.疼痛客观化指标在膝骨关节炎患者膝关节功能和疼痛评价中的应用[J].中医正骨,2013,25(9):22-24.
[4] 蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2005:119-121.
[5] 周宏,马仁超.弯角椎体成形术与传统PVP手术治疗骨质疏松性椎体压缩骨折的疗效对比[J].颈腰痛杂志,2019,40(2):194-196.
[6] 马航展,马金火,褚学远,等.单侧入路椎体成形术治疗骨质疏松性胸腰椎骨折[J].中国矫形外科杂志,2019,27(12):1068-1072.
[7] 龙淼.骨水泥弥散范围对单侧穿刺PVP术治疗骨质疏松性椎体压缩性骨折疗效的影响[J].颈腰痛杂志,2017,38(4):364-367.
[8] 贺双军,吕南宁,刘昊,等.经皮椎体后凸成形术骨水泥分布形态对术后早期疗效的影响[J].中华骨科杂志,2019,39(3):137-143.
[9] 谢华,李继春,何劲,等.骨水泥分布对椎体成形手术后疗效影响的研究[J].中华骨科杂志,2017,37(22):1400-1406.
[10] 钟远鸣,苏之盟,覃海飚,等.椎体成形术骨水泥弥散情况对再发骨折的影响[J].重庆医学,2016,45(6):752-755.
[11] JENSEN M E,EVANS A J,MATHIS J M,et al.Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures:technical aspects[J].AJNR Am J Neuroradiol,1997,18(10):1897-1904.
[12] SAXENA A,HAKIMELAHI R,JHA R M,et al.The safety and effectiveness of a curved needle for vertebral augmentation:comparison with traditional techniques[J].J Vasc Interv Radiol,2010,21(10):1548-1553.
[13] 刘相英,刘建军,李士民.应用浸骨水泥明胶海绵预防经皮椎体成形术中骨水泥渗漏[J].中医正骨,2018,30(10):74-75.
[14] 张大鹏,毛克亚,强晓军.弯角装置单侧穿刺经皮椎体成形术治疗Kümmell病的临床疗效[J].脊柱外科杂志,2017,15(6):335-338.

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备注/Memo

备注/Memo:
(收稿日期:2019-08-14 本文编辑:李晓乐)基金项目:河南省中医药科学研究专项课题(2019ZY2091); 河南省青苗人才培养项目(豫中医科教[2018]16号)通讯作者:崔宏勋 E-mail:chx6542@126.com
更新日期/Last Update: 2020-01-15