Wang Hongwei, Zheng Bin, Gu Hongwen, Zhao Yuanhang, Liu Da, Yu Hailong, Xiang Liangbi
Department of Orthopedics, General Hospital of Northern Theater Command of Chinese PLA, Shenyang 110016, China.
Department of Orthopedics, General Hospital of Western Theater Command of Chinese PLA, Chengdu 610083, China.
J Pers Med. 2023 Mar 29;13(4):595. doi: 10.3390/jpm13040595.
With the ageing of the global population, the incidence of osteoporotic vertebral compression fractures (OVCFs) is increasing. To assess the safety and efficacy of O-arm- and guide-device-assisted personalized percutaneous kyphoplasty (PKP) for treating thoracolumbar OVCFs, a total of 38 consecutive thoracolumbar OVCF patients who underwent bilateral PKP assisted with an O-arm and a guide device (O-GD group, = 16) or traditional fluoroscopy (TF group, = 22) from January 2020 to December 2021 were retrospectively reviewed, and their epidemiologic, clinical and radiological outcomes were analysed. The operation time was significantly decreased ( < 0.001) in the O-GD group (38.3 ± 12.2 min) compared with the TF group (57.2 ± 9.7 min). The number of intraoperative fluoroscopy exposures was significantly decreased ( < 0.001) in the O-GD group (31.9 ± 4.5) compared with the TF group (46.7 ± 7.2). Intraoperative blood loss was significantly decreased ( = 0.031) in the O-GD group (6.9 ± 2.5 mL) compared with the TF group (9.1 ± 3.3 mL). No significant difference ( = 0.854) in the volume of injected cement was observed between the O-GD group (6.8 ± 1.3 mL) and the TF group (6.7 ± 1.7 mL). Both the clinical and radiological outcomes, including the visual analogue scale score for pain, Oswestry Disability Index and anterior height and local kyphotic angle of the fractured vertebrae, were significantly improved at the postoperative and final follow-up but did not differ between the two groups. The incidence of cement leakage and refracture of the vertebral body was similar in the two groups ( = 0.272; = 0.871). Our preliminary study demonstrated that O-GD-assisted PKP is a safe and effective procedure that presents a significantly shorter operation time, fewer intraoperative fluoroscopy exposures and less intraoperative blood loss than the TF technique.
随着全球人口老龄化,骨质疏松性椎体压缩骨折(OVCFs)的发病率正在上升。为了评估O型臂和导向装置辅助的个性化经皮椎体后凸成形术(PKP)治疗胸腰椎OVCFs的安全性和有效性,回顾性分析了2020年1月至2021年12月期间连续38例接受双侧PKP治疗的胸腰椎OVCF患者,其中16例采用O型臂和导向装置辅助(O-GD组),22例采用传统透视(TF组),并分析了他们的流行病学、临床和放射学结果。与TF组(57.2±9.7分钟)相比,O-GD组(38.3±12.2分钟)的手术时间显著缩短(P<0.001)。与TF组(46.7±7.2)相比,O-GD组(31.9±4.5)的术中透视曝光次数显著减少(P<0.001)。与TF组(9.1±3.3毫升)相比,O-GD组(6.9±2.5毫升)的术中失血量显著减少(P=0.031)。O-GD组(6.8±1.3毫升)和TF组(6.7±1.7毫升)之间注入骨水泥的体积没有显著差异(P=0.854)。术后和最终随访时,临床和放射学结果均显著改善,包括疼痛视觉模拟评分、Oswestry功能障碍指数以及骨折椎体的前缘高度和局部后凸角,但两组之间没有差异。两组骨水泥渗漏和椎体再骨折的发生率相似(P=0.272;P=0.871)。我们的初步研究表明,O-GD辅助的PKP是一种安全有效的手术方法,与TF技术相比,手术时间显著缩短,术中透视曝光次数更少,术中失血量更少。