Wang Xiang-fu, Fan You-fu, Shi Rui-fang, Deng Qiang, Li Zhong-feng
Zhongguo Gu Shang. 2015 Aug;28(8):704-7.
To explore the relationship of bone cement distribution and the puncture angle in the treatment of thoracolumbar compression fractures with unilateral percutaneous kyphoplasty (PKP).
The clinical data of 37 patients with thoracolumbar osteoporotic compression fractures underwent PKP between January 2013 to March 2014 were retrospectively analyzed, all punctures were performed unilaterally. There were 6 males, aged from 65 to 78 years old with an average of (71.83 ± 6.15) years; and 31 females, aged from 57 to 89 years old with an average of (71.06 ± 7.89) years. Imaging data were analyzed and puncture angle and puncture point were measured before operation. According to the measured data, the puncture were performeds during the operation. Distribution area of bone cement were calculated by X-rays data after operation. The effect of bone cement distribution on suitable puncture angle was analyzed; VAS score was used to evaluate the clinical effects.
The puncture angle of thoracic vertebrae in T8-T12 was from 28° to 33° with an average 30.4°; and the puncture angle of lumbar vertebrae in L1-L5 was from 28° to 35° with an average of 31.3°. Postoperative X-rays showed the area ratios of bilateral bone cement was 0.97 ± 0.15. Bilateral diffuse area were basic equal. Postoperative VAS score decreased significantly (1.89 ± 1.29 vs 7.03 ± 1.42).
Through measure imaging data before operation with PKP,the puncture point and entry point can be confirmed. According the measured data to puncture during operation, unilateral puncture can reach the distribution effect of the bilateral puncture in the treatment of thoracolumbar compression fractures.
探讨单侧经皮椎体后凸成形术(PKP)治疗胸腰椎压缩性骨折时骨水泥分布与穿刺角度的关系。
回顾性分析2013年1月至2014年3月行PKP治疗的37例胸腰椎骨质疏松性压缩骨折患者的临床资料,均为单侧穿刺。其中男性6例,年龄65~78岁,平均(71.83±6.15)岁;女性31例,年龄57~89岁,平均(71.06±7.89)岁。术前分析影像学资料,测量穿刺角度和穿刺点。根据测量数据在术中进行穿刺。术后通过X线数据计算骨水泥分布面积。分析骨水泥分布对合适穿刺角度的影响;采用视觉模拟评分法(VAS)评估临床疗效。
T8~T12胸椎穿刺角度为28°~33°,平均30.4°;L1~L5腰椎穿刺角度为28°~35°,平均31.3°。术后X线显示双侧骨水泥面积比为0.97±0.15,双侧弥散面积基本相等。术后VAS评分显著降低(1.89±1.29 vs 7.03±1.42)。
通过PKP术前测量影像学数据,可确定穿刺点和进针点。术中根据测量数据进行穿刺,单侧穿刺在胸腰椎压缩性骨折治疗中可达到双侧穿刺的分布效果。