Department of Spine Surgery, Tongling People's Hospital, Tongling, 244000, Anhui, China.
BMC Musculoskelet Disord. 2023 Apr 5;24(1):268. doi: 10.1186/s12891-023-06387-w.
In this study, we introduced a design of a targeted puncture trajectory applied to unilateral extrapedicular percutaneous vertebroplasty.
62 individuals with osteoporotic vertebral compression fractures (OVCF) were included in this research at the Tongling People's Hospital, from January 2019 to December 2020. Percutaneous Vertebroplasty (PVP) was performed on all patients using a targeted unilateral extrapedicular puncture technique guided by G-arm fluoroscopy. The operating time, volume and dispersion of bone cement, and cement leak were all evaluated. The oswestry disability index(ODI) and the visual analog scale (VAS) were used to assess pain relief and quality of life (QOL).
The targeted puncture trajectory for unilateral extrapedicular PVP was used to successfully treat a total of 62 fractured vertebrae without any apparent clinical issues. In comparison to their equivalent preoperative values, the VAS and ODI values after surgery were considerably lower (P < 0.01). The bone cement not only could be across the midline of the targeted vertebrae but also appeared in both the bilateral pedicle and the center projection region on the anteroposterior X-ray film, according to radiologic results in all injured vertebrae. There were 3 cases of leakage at the anterior border of the vertebral body and 2 cases of leakage into the intervertebral region without significant clinical manifestations. Furthermore, no bone cement leaked into the vessels or spinal canal.
The design of the targeted puncture trajectory used in unilateral extrapedicular PVP not only ensures that the bone cement injector transcends the midline of the vertebral body, but it also improves the accuracy of the injector arriving at the contralateral pedicle projection area. As a result, this approach can increase well-distributed bone cement diffusion while preventing cement leakage into the spinal canal.
本研究介绍了一种靶向穿刺轨迹设计，应用于单侧经皮椎弓根外椎体成形术。
2019 年 1 月至 2020 年 12 月，我们在铜陵市人民医院对 62 例骨质疏松性椎体压缩性骨折（OVCF）患者进行了研究。所有患者均采用 G 臂透视引导的靶向单侧经皮椎弓根外穿刺技术进行经皮椎体成形术（PVP）。评估手术时间、骨水泥体积和分布、骨水泥渗漏情况。采用 Oswestry 功能障碍指数（ODI）和视觉模拟评分（VAS）评估疼痛缓解和生活质量（QOL）。
62 个骨折椎体采用单侧经皮椎弓根外 PVP 靶向穿刺轨迹治疗，无明显临床问题。与术前相比，术后 VAS 和 ODI 明显降低（P<0.01）。所有伤椎的前后位 X 线片均可见骨水泥不仅可跨越靶向椎体中线，而且双侧椎弓根及中心投影区均有骨水泥显影。3 例椎体前缘有渗漏，2 例有渗漏至椎间区，但无明显临床表现。此外，无骨水泥漏入血管或椎管。
单侧经皮椎弓根外 PVP 中靶向穿刺轨迹的设计不仅确保骨水泥注射器跨越椎体中线，而且提高了注射器到达对侧椎弓根投影区的准确性。因此，这种方法可以增加骨水泥的均匀扩散，同时防止骨水泥渗漏入椎管。
