| 马树伟,吴继功,陈志明,等.同步单侧入路椎体后凸成形术治疗伴轻度侧凸的跳跃型双节段骨质疏松性椎体压缩骨折.骨科,2025,16(1): 1-7. |
| 同步单侧入路椎体后凸成形术治疗伴轻度侧凸的跳跃型双节段骨质疏松性椎体压缩骨折 |
| Clinical efficacy of synchronous unilateral approach percutaneous kyphoplasty in the treatment of skipping double osteoporotic vertebral compression fractures with mild degenerative scoliosis |
| 投稿时间：2024-11-21 |
| DOI：10.3969/j.issn.1674-8573.2025.01.001 |
| 中文关键词: 骨质疏松性椎体压缩骨折 脊柱侧凸 单侧穿刺 经皮椎体后凸成型术 |
| 英文关键词: Osteoporotic vertebral compression fracture Scoliosis Unilateral puncture Percutaneous kyphoplasty |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨同步单侧椎弓根入路行经皮椎体后凸成形术（PKP）治疗伴轻度退行性侧凸的跳跃型双节段骨质疏松性椎体压缩骨折（OVCF）的临床疗效。方法 对2020年1月至2022年1月于我中心接受治疗的36例跳跃型双节段OVCF病人进行回顾性分析，所有病人均在“G”型臂X线机引导下行同步单侧椎弓根入路PKP治疗。根据伴或不伴退行性侧凸分为侧凸组和非侧凸组，侧凸组16例，男2例，女14例；年龄64~76岁，平均69.94岁；非侧凸组20例，男3例，女17例；年龄60~77岁，平均68.42岁。比较两组病人手术时间、术中透视次数、伤椎骨水泥注入量、手术前后伤椎后凸角、疼痛视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）；比较侧凸组术前、术后侧凸Cobb角。结果 侧凸组的手术时间长于非侧凸组[（56.55±5.99） min vs. （40.35±4.59） min]，透视次数多于非侧凸组[（26.18±5.31）次 vs. （21.62±3.42）次]，差异有统计学意义（P＜0.05）。两组VAS评分、ODI自术前、术后即刻、术后12个月逐步下降，组内比较，差异有统计学意义（P＜0.05），但组间比较，差异无统计学意义（P＞0.05）。两组术后头、尾侧椎体后凸Cobb角均较术前明显改善，差异有统计学意义（P＜0.05），但同一时间点两组间比较，差异无统计学意义（P＞0.05）。侧凸组术后即刻的侧凸Cobb角为9.94°±2.05°，术后3个月为9.87°±1.56°，术后12个月为9.31°±1.30°，均较术前（13.19°±1.33°）有明显改善，差异有统计学意义（P＜0.05）。结论 同步单侧椎弓根入路PKP治疗伴退行性侧凸的跳跃型双节段胸腰椎OVCF可获得满意的临床疗效，但与相同术式治疗不伴侧凸的该类病人相比，手术时间略有增加。 |
| 英文摘要: |
| Objective To investigate the clinical efficacy of synchronous unilateral approach percutaneous kyphoplasty (PKP) in the treatment of skipping double osteoporotic vertebral compression fractures (OVCF) with degenerative scoliosis. Methods A total of 36 patients with skipping double OVCF who were treated in our center from January 2020 to January 2022 were retrospectively analyzed. All patients were treated with synchronous unilateral pedicle approach PKP under G-arm guidance. They were divided into scoliosis group and non-scoliosis group. In scoliosis group, there were 2 males and 14 females; the age was 64-76 years old, with an average of 69.94 years. In the non-scoliosis group, there were 3 males and 17 females; the age was 60-77 years old, with an average of 68.42 years old. The operating time, intraoperative fluoroscopic times, the amount of bone cement injected into the injured vertebra, the kyphotic angle of the injured vertebra before and after surgery, the visual analogue scale (VAS) score, and the Oswestry disability index (ODI) were compared between the two groups. The Cobb angle of scoliosis before and after surgery was compared in the scoliosis group. Results The operation time in the scoliosis group was longer than that in the non-scoliosis group [(56.55±5.99) min vs. (40.35±4.59) min], the intraoperative fluoroscopic times were more than the non-scoliosis group [(26.18±5.31) times vs. (21.62±3.42) times], and the difference were statistically significant (P＜0.05). The VAS scores and ODI of the two groups gradually decreased before surgery, immediately after surgery, and 12 months after surgery, there were statistically significant differences within the groups (P＜0.05), but there was no statistically significant difference between the groups (P＞0.05). Both groups showed significant improvement in Cobb angles of posterior and caudal vertebral bodies after surgery, with statistical significance (P＜0.05). However, at the same time point, there was no statistically significant difference between the two groups (P＞0.05). The Cobb angle of scoliosis in the scoliosis group immediately after surgery was 9.94°±2.05°, 9.87°±1.56° at 3rd month after surgery, and 9.31°±1.30° at 12th month after surgery, all of which showed significant improvement compared to preoperation (13.19°±1.33°), and the differences were statistically significant (P＜0.05). Conclusion Synchronous unilateral approach PKP for the treatment of skipping double thoracolumbar OVCF with degenerative scoliosis can achieve satisfactory clinical results, but the operation time is slightly increased compared with the same procedure for treating such patients without scoliosis. |
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