Yu Weibo, Liang De, Jiang Xiaobing, Yao Zhensong, Qiu Ting, Ye Linqiang
Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China.
Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China.
J Neurointerv Surg. 2017 Nov;9(11):1113-1117. doi: 10.1136/neurintsurg-2016-012690. Epub 2016 Nov 9.
To compare the efficacy and safety of our target puncture technique with the traditional technique during percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs) with intravertebral clefts (IVCs).
104 patients treated with PKP for single OVCFs with IVCs were retrospectively reviewed. All patients were divided into three groups: cleft filling by the traditional technique (Group A, n=18); interdigitated filling (Group B, n=50); and overfilling by the target technique (Group C, n=36). Oswestry disability index (ODI) and visual analog scale (VAS) scores and radiological evidence of vertebral body height and kyphotic angle, cement leakage, and adjacent vertebral fractures were studied before and after surgery (immediate, 1 and 2 years).
The ODI and VAS scores decreased for all patients and no significant difference was found between the three groups after treatment. However, 1 and 2 years after surgery a greater increase in ODI and VAS scores was observed in Group A compared with the other two groups. The initial correction of vertebral body height and kyphotic angle was not significant among the three groups. However, loss of correction was greater in Group A. No significant difference was found in cement leakage. The incidence of adjacent vertebral fractures in Group C was higher than in the other two groups.
Different puncture techniques were initially effective for all patients with IVCs. However, cement cleft filling by the traditional technique was found to have less stability causing higher VAS/ODI scores and greater loss of correction. Hence, our target puncture technique was recommended in this study.
比较在经皮椎体后凸成形术（PKP）治疗伴有椎体内裂隙（IVC）的骨质疏松性椎体压缩骨折（OVCF）过程中，我们的靶向穿刺技术与传统技术的疗效和安全性。
回顾性分析104例行PKP治疗单节段伴有IVC的OVCF患者。所有患者分为三组：传统技术裂隙填充组（A组，n = 18）；交叉填充组（B组，n = 50）；靶向技术超填充组（C组，n = 36）。研究手术前后（即刻、1年和2年）的Oswestry功能障碍指数（ODI）、视觉模拟评分（VAS），以及椎体高度、后凸角、骨水泥渗漏和相邻椎体骨折的影像学证据。
所有患者的ODI和VAS评分均降低，治疗后三组间无显著差异。然而，术后1年和2年，A组的ODI和VAS评分较其他两组有更大幅度的升高。三组间椎体高度和后凸角的初始矫正无显著差异。然而，A组的矫正丢失更大。骨水泥渗漏方面无显著差异。C组相邻椎体骨折的发生率高于其他两组。
不同的穿刺技术最初对所有伴有IVC的患者均有效。然而，发现传统技术的骨水泥裂隙填充稳定性较差，导致VAS/ODI评分较高且矫正丢失更大。因此，本研究推荐使用我们的靶向穿刺技术。
