Jiang Weili, Niu Guoqi, Zhou Gong, Liu Tao, Zhang Qingbo, Liu Lutan, Cheng Jiawei
Department of Spinal Surgery, the Second Affiliated Hospital of Bengbu Medical College, Bengbu Anhui, 233002, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Sep 15;35(9):1155-1160. doi: 10.7507/1002-1892.202103018.
To investigate the effectiveness of synchronous unilateral percutaneous kyphoplasty (PKP) in the treatment of double noncontiguous thoracolumbar osteoporotic vertebral compression fracture (OVCF).
Between December 2018 and September 2020, 27 patients with double noncontiguous thoracolumbar OVCF were treated by synchronous unilateral PKP. There were 11 males and 16 females, with an average age of 75.4 years (range, 66-92 years). The fractures were caused by falls in 22 cases and sprains in 5 cases. The time from injury to hospital admission was 0.5-7.0 days, with an average of 2.1 days. The fractured vertebrae located at T in 2 cases, T in 3 cases, T in 10 cases, T in 15 cases, L in 12 cases, L in 6 cases, L in 4 cases, and L in 2 cases. The volume of bone cement injected into each vertebral body, operation time, and intraoperative fluoroscopy times were recorded. Anteroposterior and lateral X-ray films of thoracolumbar spine were taken to observe the anterior height of the injured vertebra, the Cobb angle of kyphosis, and the diffusion and good distribution rate of bone cement in the thoracolumbar spine. Visual analogue scale (VAS) score and Oswestry disability index (ODI) were used to evaluate the pain and functional improvement.
All operations completed successfully. The operation time was 34-70 minutes, with an average of 45.4 minutes. The intraoperative fluoroscopy was 21- 60 times, with an average of 38.6 times. The volume of bone cement injected into each vertebral body was 2-9 mL, with an average of 4.3 mL. All patients were followed up 6-21 months, with an average of 11.3 months. X-ray film reexamination showed that the anterior height of the injured vertebra and Cobb angle at each time point after operation were significantly improved than those before operation ( <0.05), and there was no significant difference between different time points after operation ( >0.05). The distribution of bone cement was excellent in 40 vertebral bodies, good in 13 vertebral bodies, and poor in 1 vertebral body, and the excellent and good rate was 98.1% (53/54). The pain of all patients significantly relieved or disappeared, and the function improved. The VAS score and ODI at each time point after operation were significantly lower than those before operation ( <0.05), and there was no significant difference between different time points after operation ( >0.05).
For the double noncontiguous thoracolumbar OVCF, the synchronous unilateral PKP has the advantages of simple puncture, less trauma, less intraoperative fluoroscopy, shorter operation time, satisfactory distribution of bone cement, . It can restore the height of the vertebral body, correct the kyphotic angle, significantly alleviate the pain, and improve the function.
探讨同步单侧经皮椎体后凸成形术（PKP）治疗双节段非连续性胸腰椎骨质疏松性椎体压缩骨折（OVCF）的疗效。
2018年12月至2020年9月，对27例双节段非连续性胸腰椎OVCF患者行同步单侧PKP治疗。其中男11例，女16例，平均年龄75.4岁（范围66 - 92岁）。骨折原因：跌倒致伤22例，扭伤5例。受伤至入院时间为0.5 - 7.0天，平均2.1天。骨折椎体位于T 2例，T 3例，T 10例，T 15例，L 12例，L 6例，L 4例，L 2例。记录每个椎体注入骨水泥的量、手术时间及术中透视次数。拍摄胸腰椎正侧位X线片，观察伤椎前缘高度、后凸Cobb角及骨水泥在胸腰椎的弥散情况和分布优良率。采用视觉模拟评分法（VAS）和Oswestry功能障碍指数（ODI）评估疼痛及功能改善情况。
所有手术均顺利完成。手术时间为34 - 70分钟，平均45.4分钟。术中透视21 - 60次，平均38.6次。每个椎体注入骨水泥量为2 - 9 mL，平均4.3 mL。所有患者随访6 - 21个月，平均11.3个月。X线片复查显示，术后各时间点伤椎前缘高度及Cobb角均较术前明显改善（ <0.05），术后不同时间点间比较差异无统计学意义（ >0.05）。骨水泥分布：优40个椎体，良13个椎体，差1个椎体，优良率为98.1%（53/54）。所有患者疼痛明显缓解或消失，功能改善。术后各时间点VAS评分及ODI均较术前明显降低（ <0.05），术后不同时间点间比较差异无统计学意义（ >0.05）。
对于双节段非连续性胸腰椎OVCF，同步单侧PKP具有穿刺简单、创伤小、术中透视少、手术时间短、骨水泥分布满意等优点，能恢复椎体高度，矫正后凸角，明显缓解疼痛，改善功能。
