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球囊经皮椎体后凸成形术与“Sky-bone扩张器”经皮椎体后凸成形术临床应用的对比研究

[A comparison study of clinical application between balloon percutaneous kyphoplasty and "Sky-bone expander" percutaneous kyphoplasty].

作者信息

Zheng Zhao-min, Kuang Guan-ming, Dong Zhi-yong, Li Fo-bao, Wan Yong

机构信息

Department of Spine Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2006 Dec 15;44(24):1667-71.

Abstract

OBJECTIVE

To compare the clinical results of balloon percutaneous kyphoplasty (PKP) and "Sky-bone expander" PKP.

METHODS

From October 2004 to February 2006, 25 cases (57 vertebrae) balloon PKP and 24 cases (29 vertebrae) "Sky-bone expander" PKP procedures were performed. The operation time, bleeding volume, cement injected volume were recorded during operation. The patients' pain relief and functional activities recovery were evaluated after operation. The distribution of the cement and the restoration of vertebral height were also observed post-operation. All these patients were followed-up by telephone or clinic consults after discharged.

RESULTS

All cases were successfully experienced procedures. There are no significant differences in operative time, bleeding volume and cost of every vertebrae in these two group (P > 0.05). The balloon group had larger cement injected volume per pedicle than Sky group (4.27 +/- 1.08) ml vs. (3.15 +/- 0.78) ml (P < 0.05). The VAS and ODI scoring of these two groups were both decreased significantly after operation. The vertebral height were restored in both two groups with anterior height and midline height restored significantly in balloon group and midline height restored significantly in Sky group. The cement distribution of "Sky-bone expander" PKP with unipediclar injection mostly limited in the injective side of the vertebral body, but most of the balloon PKP vertebrae with unipediclar injection can be seen a cross-midline cement distribution in the anterior-posterior position X ray film.

CONCLUSIONS

Both balloon PKP and "Sky-bone expander" PKP are efficacious and safety in the treatment of vertebral compression fractures. "Sky-bone expander" PKP is more suitable for single level compressive fracture while balloon PKP is especially suitable for multiple level compressive fractures.

摘要

目的

比较球囊经皮椎体后凸成形术(PKP)与“Sky骨扩张器”PKP的临床效果。

方法

2004年10月至2006年2月,分别对25例(57个椎体)实施球囊PKP手术和24例(29个椎体)实施“Sky骨扩张器”PKP手术。术中记录手术时间、出血量、骨水泥注入量。术后评估患者疼痛缓解情况及功能活动恢复情况。术后还观察骨水泥分布及椎体高度恢复情况。所有患者出院后通过电话或门诊随访。

结果

所有病例手术均成功。两组间每个椎体的手术时间、出血量及费用差异无统计学意义(P>0.05)。球囊组每个椎弓根注入的骨水泥量大于Sky组,分别为(4.27±1.08)ml对(3.15±0.78)ml(P<0.05)。两组术后视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评分均显著降低。两组椎体高度均有恢复,球囊组椎体前缘高度和中线高度恢复明显,Sky组中线高度恢复明显。“Sky骨扩张器”PKP单侧椎弓根注射时骨水泥分布大多局限于椎体注射侧,但球囊PKP单侧椎弓根注射的大多数椎体在前后位X线片上可见骨水泥跨中线分布。

结论

球囊PKP和“Sky骨扩张器”PKP治疗椎体压缩骨折均有效且安全。“Sky骨扩张器”PKP更适合单节段压缩骨折,而球囊PKP尤其适合多节段压缩骨折。

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