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O 臂导航辅助经皮椎体后凸成形术治疗 T6 至 T9 椎体骨质疏松性椎体压缩性骨折的安全性和有效性。

Safety and efficacy of percutaneous kyphoplasty assisted with O-arm navigation for the treatment of osteoporotic vertebral compression fractures at T6 to T9 vertebrae.

机构信息

Department of Orthopedics, The First Affiliated Hospital of Soochow University, 899, Pinhai Road, Suzhou, 215006, China.

Orthopedic Institute, Soochow University, Suzhou, 215006, China.

出版信息

Int Orthop. 2020 Feb;44(2):349-355. doi: 10.1007/s00264-019-04444-5. Epub 2019 Dec 18.

DOI:10.1007/s00264-019-04444-5
PMID:31853584
Abstract

PURPOSE

To evaluate the safety and efficacy of PKP under O-arm navigation system guidance for treating middle thoracic OVCF (T6~T9).

METHODS

A retrospective study was conducted for 44 consecutive T6~T9 OVCF patients who received PKP assisted with O-arm navigation (n = 20) or fluoroscopy (n = 24) from January 2016 to December 2017. Demographic data, radiographic parameters, and clinical outcomes were collected and analyzed at pre-operative, post-operative, and final follow-up period. Complications including tissue lesion, needle malposition, and leakage of bone cement were also recorded amid operation.

RESULTS

A total of 44 patients (4 males and 40 females, with mean age of 71.1 ± 8.7) were enrolled in this study, and the mean follow-up time was 14.4 months. In surgical details, navigation system could obtain more satisfactory volume of injected cement and less loss of blood, as well did not increase surgical time compared with fluoroscopy. Both radiological and clinical outcomes improved significantly at post-operative and final follow-up, while did not differed between two groups. For adverse events, the incidence of cement leakage was similar between two groups. However, O-arm navigation can achieve lower rate of complications than fluoroscopy.

CONCLUSION

Our preliminary study demonstrated that PKP assisted with O-arm navigation is a safe and effective procedure that applied for middle thoracic OVCF (T6~T9), which can achieve favourable radiological and clinical outcomes, and low rate of complications.

摘要

目的

评估在 O 臂导航系统引导下经皮椎体后凸成形术(PKP)治疗 T6~T9 段中胸椎体骨质疏松性骨折(OVCF)的安全性和有效性。

方法

回顾性分析 2016 年 1 月至 2017 年 12 月采用 O 臂导航(n=20)或透视(n=24)辅助 PKP 治疗的 T6~T9 段 OVCF 患者 44 例的临床资料。记录并比较患者术前、术后及末次随访时的一般资料、影像学参数和临床疗效,记录手术并发症(包括骨水泥渗漏、骨水泥外溢、穿刺部位相关并发症等)。

结果

共纳入 44 例患者(男 4 例,女 40 例;年龄 71.1±8.7 岁),随访时间 14.4 个月。与透视组比较,导航组手术时间无明显延长,但术中可获得更多的骨水泥量,出血量更少。术后及末次随访时患者影像学及临床疗效较术前均明显改善,两组间差异无统计学意义。透视组并发症发生率与导航组相似,但导航组穿刺部位相关并发症发生率更低。

结论

初步研究表明,O 臂导航辅助 PKP 治疗 T6~T9 段中胸 OVCF 安全有效,可获得满意的临床及影像学疗效,且并发症发生率较低。

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