本文選題：單側(cè)入路 + 雙側(cè)入路　； 參考：《蘇州大學(xué)》2015年碩士論文

【摘要】：目的:比較單側(cè)與雙側(cè)入路經(jīng)皮椎體后凸成形術(shù)治療多節(jié)段胸腰椎骨質(zhì)疏松性壓縮骨折的早期臨床療效。方法:回顧性分析2012年1月至2014年12月入院并接受PKP手術(shù)治療的50例多節(jié)段胸腰椎骨質(zhì)疏松壓縮性骨折患者,共計123椎,按照手術(shù)入路分為雙側(cè)入路組25例61椎,單側(cè)入路組25例62椎,對患者術(shù)前、術(shù)后3天及術(shù)后3月進行腰背部疼痛視覺模擬評分(V A S)、術(shù)后Cobb角、術(shù)椎椎體高度的恢復(fù)范圍以及手術(shù)時間、術(shù)中透視次數(shù)、骨水泥使用量及骨水泥滲透率的比較。結(jié)果:兩組患者PKP術(shù)均順利完成。兩組患者術(shù)后3天及術(shù)后3月VAS評分較術(shù)前明顯降低,P值均0.05,提示兩種入路PKP術(shù)均能有效緩解OVCF患者疼痛。兩組患者術(shù)后3天及術(shù)后3月椎體高度較術(shù)前恢復(fù),P值均0.05,提示兩種入路PKP術(shù)均能恢復(fù)椎體高度,兩組間進行對比,P值均0.05,提示兩組間椎體高度恢復(fù)無統(tǒng)計學(xué)差異。兩組患者術(shù)后Cobb角較術(shù)前減小,P值均0.05,提示兩種入路PKP術(shù)均能糾正脊柱后凸畸形,兩組間進行對比,P值均大于0.05,提示兩組間cobb角恢復(fù)無統(tǒng)計學(xué)差異。對比兩組間手術(shù)時間、術(shù)中透視次數(shù)、骨水泥使用量,P均0.05,提示兩組間具有明顯統(tǒng)計學(xué)差異。對比兩組間骨水泥滲漏率,P大于0.05,提示無明顯統(tǒng)計學(xué)差異。結(jié)論:單側(cè)及雙側(cè)入路PKP術(shù)治療多節(jié)段胸腰椎骨質(zhì)疏松壓縮性骨折均能達到比較滿意的效果。相比較雙側(cè)入路,單側(cè)入路PKP術(shù)具有手術(shù)時間短,放射暴露少,等優(yōu)點。但單側(cè)穿刺其難度和要求相應(yīng)提高,而骨水泥的滲漏并不減少。
[Abstract]:Objective: to compare the early clinical effects of unilateral and bilateral percutaneous kyphoplasty in the treatment of multiple thoracolumbar osteoporotic compression fractures. Methods: from January 2012 to December 2014, 50 patients with multiple thoracolumbar vertebral osteoporotic compression fractures who were admitted to hospital from January 2012 to December 2014 and received PKP surgery were retrospectively analyzed. The patients were divided into two groups according to the surgical approach: 25 cases (61 vertebrae) with bilateral approach. In the unilateral approach group, 25 cases (62 vertebrae) were treated with visual analogue score of lumbar and back pain before operation, 3 days after operation and 3 months after operation. The postoperative Cobb angle, the recovery range of vertebral body height, the time of operation, and the times of fluoroscopy were performed. Comparison of bone cement usage and bone cement permeability. Results: PKP was performed successfully in both groups. The VAS scores of the two groups were significantly decreased by 0.05 on the 3rd day after operation and 3 months after operation, indicating that the two approaches of PKP can effectively relieve the pain of OVCF patients. The vertebral body height of the two groups was 0. 05 on the 3rd day after operation and 3 months after operation, indicating that the vertebral body height could be recovered by PKP through the two approaches, and the P value of the two groups was 0. 05, indicating that there was no significant difference in the recovery of the vertebral body height between the two groups. The decrease of Cobb angle after operation in both groups was 0.05, indicating that the two approaches of PKP could correct kyphosis, and the P value of the two groups was greater than 0.05, indicating that there was no significant difference in the recovery of cobb angle between the two groups. The time of operation, the times of fluoroscopy and the dosage of bone cement were 0.05, which indicated that there was significant difference between the two groups. There was no significant difference between the two groups in bone cement leakage rate (P > 0.05). Conclusion: unilateral and bilateral approaches of PKP in the treatment of multiple thoracolumbar vertebral osteoporotic compression fractures can achieve satisfactory results. Compared with bilateral approach, unilateral approach PKP has the advantages of shorter operative time, less radiation exposure, and so on. However, the difficulty and requirement of unilateral puncture are increased, and the leakage of bone cement is not reduced.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3

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