Department of Orthopedic Surgery, Bengbu Medical College Lianyungang Clinical College, The Second People's Hospital of Lianyungang, 41 Hailian East Street, Lianyungang, 222003, Jiangsu, China.
Department of Orthopedic Surgery, Bengbu Medical College, Bengbu, Anhui, China.
BMC Surg. 2022 Sep 30;22(1):351. doi: 10.1186/s12893-022-01750-5.
Intravertebral cleft is common in osteoporotic vertebral compression fracture, and the bone sclerosis around the fissure brings difficulties to the surgical treatment. It is not known whether the balloon dilatation mode of percutaneous kyphoplasty affects the distribution of bone cement in the fracture vertebral body and further affects the surgical effect. The purpose of this study was to discuss the effect of balloon dilatation mode on percutaneous kyphoplasty in the treatment of osteoporotic vertebral fractures with intravertebral cleft.
According to the inclusion criteria and exclusion criteria, a retrospective analysis of patients with osteoporotic vertebral fracture combined with intravertebral cleft treated by percutaneous kyphoplasty in our hospital was conducted. All patients were divided into two groups based on way of balloon dilation. The mode of balloon dilatation, imaging changes of vertebral body, VAS score, ODI score, bone cement distribution and postoperative complications were analyzed.
A total of 96 patients with osteoporotic vertebral fracture combined with intravertebral cleft were included in the study, including 51 patients treated with single balloon bilateral alternating dilatation technique and 45 patients treated with double balloon bilateral dilatation technique. The vertebral height, Cobb's angle of kyphosis, VAS score and ODI score were significantly improved in both groups after operation (P < 0.05). The postoperative vertebral height and Cobb's angle of kyphosis in the double balloon bilateral dilatation group were better than those in single balloon bilateral alternating dilatation group (P < 0.05). The distribution of bone cement in the single balloon bilateral alternating dilatation group was more inclined to insert filling, while the double balloon bilateral dilatation group was more inclined to fissure filling. The VAS score and ODI score at the final follow-up in the single balloon bilateral alternating dilatation group were lower than those in the double balloon bilateral dilatation group (P < 0.05).
Double balloon bilateral dilatation technique can better restore the injured vertebral height in patients with osteoporotic vertebral fracture combined with intravertebral cleft. However, the distribution of injured vertebral cement in patients with single balloon bilateral alternating dilatation technique is more likely to be inserted and filled, and the long-term analgesia and lumbar function of patients are better.
在骨质疏松性椎体压缩性骨折中,椎体内裂隙很常见,裂隙周围的骨硬化给手术治疗带来了困难。目前尚不清楚经皮椎体后凸成形术的球囊扩张方式是否会影响骨折椎体骨水泥的分布,进而影响手术效果。本研究旨在探讨球囊扩张方式对伴有椎体内裂隙的骨质疏松性椎体骨折行经皮椎体后凸成形术的影响。
根据纳入标准和排除标准,对我院收治的经皮椎体后凸成形术治疗的骨质疏松性椎体骨折合并椎体内裂隙患者进行回顾性分析。所有患者均根据球囊扩张方式分为两组,球囊扩张方式、椎体影像学变化、视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)评分、骨水泥分布及术后并发症进行分析。
共纳入 96 例骨质疏松性椎体骨折合并椎体内裂隙患者,其中 51 例行单球囊双侧交替扩张技术,45 例行双球囊双侧扩张技术。两组术后椎体高度、后凸 Cobb 角、VAS 评分和 ODI 评分均明显改善(P < 0.05)。双球囊双侧扩张组术后椎体高度和后凸 Cobb 角优于单球囊双侧交替扩张组(P < 0.05)。单球囊双侧交替扩张组骨水泥分布更倾向于插入填充,双球囊双侧扩张组更倾向于裂隙填充。单球囊双侧交替扩张组末次随访时 VAS 评分和 ODI 评分均低于双球囊双侧扩张组(P < 0.05)。
双球囊双侧扩张技术可更好地恢复骨质疏松性椎体骨折合并椎体内裂隙患者的伤椎高度。然而,单球囊双侧交替扩张技术中伤椎骨水泥的分布更倾向于插入填充,且患者的长期镇痛和腰椎功能更好。