一种新的单侧经椎弓根外途径应用于经皮椎体强化治疗胸腰椎骨质疏松性椎体压缩骨折:回顾性研究。
A novel unilateral extrapedicular approach applied to percutaneous vertebral augmentation to treat thoracic and lumbar Osteoporotic Vertebral Compression Fracture: a retrospective study.
机构信息
Department of Spinal Surgery Ward 1, Hanzhong Central Hospital, 22Kangfu Road, Hanzhong, Shaanxi, 723000, China.
出版信息
BMC Musculoskelet Disord. 2024 Oct 30;25(1):868. doi: 10.1186/s12891-024-07980-3.
OBJECTIVE
To design and apply a novel puncture method, named P TO P technique, and to evaluate its efficacy and safety.
METHOD
The data of patients treated with PVA in medical institution from January 2020 to December 2022 were reviewed and analyzed. The degree of pain relief and recovery from daily activities were evaluated using VAS and LAS scores, and radiological parameters were evaluated using local kyphosis angle and excellent cement distribution. Complications such as cement leakage and recurrent vertebral fractures were also recorded.
RESULTS
157 patients with thoracolumbar OVCF were successfully treated with novel puncture techniques. All postoperative clinical and radiological parameters significantly decreased in all patients, except for an increase in local kyphosis angle at the last follow-up compared to postoperative. All other above indicators remained statistically significant at the last follow-up compared to postoperative improvement. Except for 2 patients with poor cement distribution, the remaining 155 patients successfully achieved satisfactory results in unilateral puncture and bilateral cement distribution, achieving an excellent rate of 98.73%. In addition, 18 cases (11.46%) of cement leakage occurred during the operation, fortunately none of them were uncomfortable. During the postoperative follow-up period, 4 cases (2.55%) of recurrent fractures occurred. No other serious complications such as neurologic or named vascular injuries occurred.
CONCLUSION
The application of P TO P technology in thoracolumbar OVCF patients is safe and effective. It can not only reduce pain and quickly recover daily activities, but also achieve the perfect effect of unilateral puncture and bilateral cement filling.
目的
设计并应用一种新的穿刺方法,即 P TO P 技术,并评估其疗效和安全性。
方法
回顾分析 2020 年 1 月至 2022 年 12 月在医疗机构接受 PVA 治疗的患者数据。采用 VAS 和 LAS 评分评估疼痛缓解程度和日常活动恢复情况,采用局部后凸角和优秀的水泥分布评估影像学参数。还记录了并发症,如水泥渗漏和复发性椎体骨折。
结果
157 例胸腰椎 OVCF 患者成功采用新的穿刺技术进行治疗。所有患者术后临床和影像学参数均显著下降,除末次随访时局部后凸角较术后增加外。与术后改善相比,所有其他上述指标在末次随访时仍具有统计学意义。除 2 例水泥分布不良外,其余 155 例单侧穿刺和双侧水泥分布均取得满意效果,优良率为 98.73%。此外,术中发生 18 例(11.46%)水泥渗漏,幸运的是均无不适。术后随访期间,发生 4 例(2.55%)复发性骨折。无其他严重并发症,如神经或命名性血管损伤。
结论
P TO P 技术在胸腰椎 OVCF 患者中的应用是安全有效的。它不仅可以减轻疼痛,快速恢复日常活动,还可以实现单侧穿刺和双侧水泥填充的完美效果。