兩種微创术式治疗未合并神经压迫新鲜胸腰椎压缩骨折临床对比研究.docVIP

两种入路下PVP术式治疗未合并神经压迫新鲜胸腰椎压缩骨折临床对比研究 【摘要】目的:探讨单侧和双侧椎弓根入路下行经皮穿刺椎体成形术治疗未合并神经压迫新鲜胸腰椎压缩骨折临床效果及安全性差异。方法：研究对象选取我院2011年3月-2014年3月收治未合并神经压迫新鲜胸腰椎压缩骨折患者共90例，以随机抽签法分为A组（45例）和B组（45例），分别采用单侧和双侧椎弓根入路下行经皮穿刺椎体成形术治疗；比较两组患者围手术期临床指标，骨水泥渗漏率，手术前后VAS评分和QUALEFFO评分等。结果：A组患者围手术期临床指标均显著优于B组（p0.05）；两组患者骨水泥渗漏率比较差异无统计学意义（p0.05）；B组患者术后3、6及12个月VAS评分均显著低于A组、术前（p0.05）；B组患者术后3、6及12个月QUALEFFO评分均显著低于A组、术前（p0.05）。结论：双侧椎弓根入路下行经皮穿刺椎体成形术治疗未合并神经压迫新鲜胸腰椎压缩骨折可有效降低远期疼痛程度，改善日常生活质量，且未增加骨水泥渗漏风险，效果优于单侧椎弓根入路。 【关键词】椎弓根；经皮穿刺椎体成形术；胸腰椎压缩骨折 Clinical comparative study of two kinds of approaches by PVP operation in the treatment of thoracolumbar vertebral compression fractures without nerve compression Abstract：Objective To investigate the clinical efficacy and safety difference of two kinds of minimally invasive surgery in the treatment of thoracolumbar vertebral compression fractures without nerve compression including unilateral and bilateral percutaneous vertebroplasty. Methods 90 patients with thoracolumbar vertebral compression fractures without nerve compression in the period from March 2011 to March 2014 in our hospital were chosen and randomly divided into both group including control group (45 patients) with unilateral bilateral percutaneous vertebroplasty. and minimally invasive group (45 patients) with bilateral percutaneous vertebroplasty; and the clinical indicators in the peri-operation period, the bone cement leakage rate, VAS score and QUALEFFO score before and after operation of both groups were compared. Results The clinical indicators in the peri-operation period of A group was significantly better than B group （p0.05）. There was no significant difference in the bone cement leakage rate between 2 groups（p0.05）. The VAS score in 3, 6 and 12 months after operation of B group was significantly lower than A group and before operation（p0.05）. The QUALEFFO score in 3, 6 and 12 months after operation of B group was significantly lower than A group and before operation（p0.05）. Conclusion Compared with unilatera