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一种用于骨质疏松性椎体压缩骨折的经椎弓根上切迹椎体后凸成形术改良轨迹:技术说明与临床结果

A modified trajectory of kyphoplasty superior pedicle notch for osteoporotic vertebral compression fractures: Technique note and clinical result.

作者信息

Jiang Yi, Li Jian, Yuan Shuai, Zuo Rujun, Liu Chang, Zhang Jiexun, Ma Ming

机构信息

Department of Orthopedics (Minimally Invasive Spine Surgery Branch), Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing, China.

出版信息

Front Surg. 2022 Sep 15;9:1012160. doi: 10.3389/fsurg.2022.1012160. eCollection 2022.

Abstract

BACKGROUND

Percutaneous extra-pedicular kyphoplasty can achieve better clinical results than transpedicular kyphoplasty. However, lumbar segment artery injury as a disaster complication limits its clinical application.

OBJECTIVE

To describe and evaluate a modified trajectory of kyphoplasty for the treatment of osteoporotic vertebral compression fractures (OVCF).

METHODS

Eighty-one patients who underwent percutaneous kyphoplasty (PKP) for lumbar OVCF at our hospital between May 2017 and May 2021 were enrolled. The patients were divided into an observation group ( the superior pedicle approach) and a control group ( the transpedicular approach) according to the surgical trajectory. The surgical procedure was described in detail, and the imaging parameters were recorded. Preoperative and postoperative clinical data were collected for statistical analysis.

RESULTS

PKP the superior pedicle notch approach could offer large abduction and cranial inclination angles without serious complications. The rate of paravertebral leakage was significantly lower in the observation group than in the control group. Surgery with a superior pedicle notch approach had a shorter operative time and fewer fluoroscopies.

CONCLUSIONS

PKP the superior pedicle notch approach is a modified extra-pedicular approach for lumbar osteoporotic vertebral compression fractures. This trajectory is an easy-to-use target position because it enters the vertebral body directly. A shorter operative time and lower radiation exposure can enhance recovery after surgery.

摘要

背景

经皮椎弓根外椎体后凸成形术比经椎弓根椎体后凸成形术能取得更好的临床效果。然而,腰段动脉损伤作为一种灾难性并发症限制了其临床应用。

目的

描述并评估一种改良的椎体后凸成形术轨迹用于治疗骨质疏松性椎体压缩骨折(OVCF)。

方法

纳入2017年5月至2021年5月在我院接受经皮椎体后凸成形术(PKP)治疗腰椎OVCF的81例患者。根据手术轨迹将患者分为观察组(经上位椎弓根入路)和对照组(经椎弓根入路)。详细描述手术过程并记录影像学参数。收集术前和术后临床资料进行统计分析。

结果

经上位椎弓根切迹入路的PKP可提供较大的外展和头倾角度且无严重并发症。观察组椎旁渗漏率明显低于对照组。经上位椎弓根切迹入路手术的手术时间较短且透视次数较少。

结论

经上位椎弓根切迹入路PKP是一种改良的腰椎骨质疏松性椎体压缩骨折椎弓根外入路。该轨迹是一个易于使用的目标位置,因为它直接进入椎体。较短的手术时间和较低的辐射暴露可促进术后恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e75/9583662/95bea97eab08/fsurg-09-1012160-g001.jpg

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