中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2018, Vol. 47 ›› Issue (1): 27-31,35.doi: 10.12007/j.issn.0258-4646.2018.01.007

• 论著 • 上一篇    下一篇

球囊二次扩张椎体后凸成形术治疗老年重度骨质疏松性椎体压缩骨折

邹倩1, 孙育良2   

  1. 1. 西南医科大学附属医院妇产科, 四川 泸州 64600;
    2. 四川省骨科医院脊柱科, 成都 610041
  • 收稿日期:2017-05-10 出版日期:2018-01-30 发布日期:2017-12-23
  • 通讯作者: 邹倩 E-mail:1376172656@qq.com
  • 作者简介:邹倩(1969-10),女,主管护师,本科.
  • 基金资助:
    四川省科技厅支撑项目(2015SZ0190)

Application of Double-balloon Dilation in Percutaneous Kyphoplasty in Severe Osteoporotic Vertebral Compression Fracture in the Elderly

ZOU Qia1, SUN Yuliang2   

  1. 1. Department of Gynecology and Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou 64600, China;
    2. Department of Spine Surgery, Sichuan Province Orthopedics Hospital, Chengdu 610041, China
  • Received:2017-05-10 Online:2018-01-30 Published:2017-12-23

摘要: 目的 探讨球囊二次扩张椎体后凸成形术治疗老年重度骨质疏松性椎体压缩骨折(OVCF)的临床疗效。方法 将60例重度OVCF患者随机分为球囊二次扩张组和球囊单次扩张组,每组30例。球囊二次扩张组行单侧穿刺球囊二次扩张椎体后凸成形术治疗,球囊单次扩张组行单侧经皮穿刺球囊扩张椎体后凸成形术治疗。术后3、6、12个月定期随访。记录手术时间、出血量、骨水泥注入量、骨水泥渗漏率,采用疼痛视觉模拟评分(VAS)、Oswestry功能障碍指(ODI)、椎体前缘高度和椎体后凸Cobb角评价疗效。结果 2组手术时间、出血量、骨水泥渗漏率的差异无统计学意义(P>0.05)。球囊二次扩张组骨水泥注入量较球囊单次扩张组多(P<0.05)。2组比较,术后1 d和术后3、6、12个月时VAS评分及ODI的差异无统计学意义(P>0.05),球囊二次扩张组的椎体前缘高度较球囊单次扩张组高(P<0.05),椎体后凸Cobb角较单次扩张组低(P<0.05)。随访过程中球囊二次扩张组有2例非手术椎体再发骨折;球囊单次扩张组有5例非手术椎体再发骨折,1例出现神经脊髓症状。结论 球囊二次扩张椎体后凸成形术治疗老年重度OVCF,能较好地恢复椎体高度,改善脊柱后凸角畸形,增加骨水泥注入量,减少骨水泥渗漏等并发症,是治疗重度OVCF的有效方法。

关键词: 椎体后凸成形术, 骨质疏松, 椎体压缩骨折, 球囊二次扩张

Abstract: Objective To evaluate the efficacy of double-balloon dilation in percutaneous kyphoplasty for severe osteoporotic vertebral compression fracture (OVCF) in the elderly. Methods Sixty patients with severe OVCF were randomly divided into two groups, a double-and a single-balloon dilatation group, with 30 cases in each group. Regular follow-up was conducted at 3, 6, and 12 months after operation. The operation time, blood loss volume, bone cement injection rate, and bone cement leakage rate were recorded. The visual analog score (VAS), Oswestry disability index (ODI), vertebral anterior height, and kyphosis Cobb angle were used to evaluate efficacy. Results No significant differences in operation time and bleeding volume were found between the 2 groups (P > 0.05). The amount of bone cement injection in the double-balloon dilatation group was more than that in the single-balloon dilatation group (P < 0.05). The bone cement leakage rate was lower than that in the single-balloon dilatation group, but the difference was not statistically significant (P > 0.05). No significant differences in VAS score and ODI were found between the 2 groups at 1 day and 3, 6, and 12 months after operation (P > 0.05), but with statistical significance of the anterior vertebral height and kyphosis Cobb angle difference (P < 0.05). During the follow-up, 2 cases of complication occurred in the double-balloon dilatation group, but 6 cases of complication occurred in the single-balloon dilatation group. Conclusion Double-balloon dilation in percutaneous kyphoplasty for elderly patients with severe OVCF can effectively alleviate clinical symptoms and reduce complications, which is an effective method for the treatment of severe OVCF.

Key words: kyphoplasty, osteoporosis, vertebral compression fracture, double balloon dilation

中图分类号: 

  • R765.2
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