Treatment Of Osteoporotic Spinal Compression Fractures by Unipedicular Vertebroplasty_West China Medical Journal

Authors：

YU Bin , CHEN Qin , DENG Ning.

The 3rd People’s hospital of Chengdu City, Chengdu Sichuan 610031, China;

Corresponding author：

Keywords：

椎体压缩骨折; 单侧穿刺; 胸腰段; 骨水泥

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目的:探讨单侧经椎弓根基底部外侧穿刺进针的可行性和安全性。方法:14例椎体压缩性骨折经椎弓根基底外侧穿刺进针,球囊扩张,骨水泥注入治疗,使用VAS评分法评价患者疼痛变化,测定手术前后椎体前、中柱高度与Cobb角。结果:单侧经椎弓根基底外侧穿刺的手术均安全完成。VAS评分由术前平均(8.5±0.3)分改善到术后(2.2±0.2)分,随访三月为(2.1±0.4)分 (与术前比较,P lt;0.05); 椎体前缘高度由术前(13.6±2.3) mm到术后(24.5±2.2) mm,随访三月为(24.3±2.0) mm(与术前比较,P lt;0.05);锥体中部高度由术前(14.2±2.1) mm到术后(25.6±2.4) mm,随访三月为(25.4±2.2) mm(与术前比较,P lt;0.05); Cobb角由术前的(22.5±3.6)°到术后(10.5±3.0)°随访三月为(10.3±2.8)°(与术前比较,P lt;0.05)。结论:经椎弓根基底外侧的单侧穿刺锥体成形术可有效恢复骨质疏松性椎体压缩性骨折椎体高度、缓解疼痛,是一种安全、有效的治疗方法,值得推广。

Citation： YU Bin,CHEN Qin,DENG Ning.. Treatment Of Osteoporotic Spinal Compression Fractures by Unipedicular Vertebroplasty. West China Medical Journal, 2009, 24(7): 1673-1675. doi: Copy

1.	安珍,杨定焯,张祖君,等.骨质疏松性脊椎压缩性骨折流行病学调查分析[J].中国骨质疏松杂志, 2002,8(1):82-83.
2.	LIEBERMAN I, REINHARDT M K. Vertebroplasty and kyphoplasty for osteolytic vertebral collapse[J]. Clin Orthop RelatRes, 2003,(415 Suppl):S176-S186.
3.	PEH W C, GILULA L A. Percutaneous vertebroplasty:indications, contraindications and technique[J]. Br J Radio,2003,76(901):69-75.
4.	COUMANS J V, REINHARDT M K, LIEBERMAN IH. Kyphoplasty for vertebral compression fractures:1year clinical outcomes from a prospective study[J].J Neurosurg. 2003;99(1 Suppl):44-50.
5.	HUSKISSON E C. Measurement of pain[J]. Lancet,1974,2(7889):1127-1131.
6.	BELKOFF S M, MATHIS J M, JASPER L E, et al.The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior[J]. Spine. 2001;26(14):1537-41.
7.	BERLEMANN U, FRANZ T, ORLER R, et al.Kyphoplasty for treatment of osteoporotic vertebral fractures:a prospective nonrandomized study[J].Eur Spine J. 2004;13(6):496-501.
8.	PAPADOPOULOS E C, EDOBOROSULA F, GARDNER M J, et al.Unipedicular balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures:early results[J]. J Spinal Disord Tech. 2008;21(8):589-96.
9.	STEINMANN J, TINGEY C T, CRUZ G, et al. Biomechanical comparison of unipedicular versus bipedicular kyphoplasty[J]. Spine,2005,30(2):201-205.
10.	COTTEN A, DEWATRE F, CORTET B, et al. Percutaneous vertebroplasty for osteolytic metastases and myeloma:effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical followup[J]. Radiology. 1996,200(2):525-30.
11.	PHILLIPS F M, PFEIFER B A, LIEBERMAN I H, et al.Minimally invasive treatments of osteoporotic vertebral compression fractures:vertebroplasty and kyphoplasty[J]. Instr Course Lect, 2003,52(3):55967.
12.	孙钢,王晨光.脊柱非血管性介入治疗学[M].济南:山东科学技术出版社,2002:146-156.
13.	DIAMOND T H, CLARK W A. Percutaneous vertbroplasty:a novel treatment for acute vertebral fracture[J]. Med J Aust, 2001,174(8):398-400.
14.	COTTEN A, BOUTRY N, CORTET B, et al. Percutaneous vertebroplasty:state of the art[J].Radiographics, 1998,18(2):311-20.

1. 安珍,杨定焯,张祖君,等.骨质疏松性脊椎压缩性骨折流行病学调查分析[J].中国骨质疏松杂志, 2002,8(1):82-83.
2. LIEBERMAN I, REINHARDT M K. Vertebroplasty and kyphoplasty for osteolytic vertebral collapse[J]. Clin Orthop RelatRes, 2003,(415 Suppl):S176-S186.
3. PEH W C, GILULA L A. Percutaneous vertebroplasty:indications, contraindications and technique[J]. Br J Radio,2003,76(901):69-75.
4. COUMANS J V, REINHARDT M K, LIEBERMAN IH. Kyphoplasty for vertebral compression fractures:1year clinical outcomes from a prospective study[J].J Neurosurg. 2003;99(1 Suppl):44-50.
5. HUSKISSON E C. Measurement of pain[J]. Lancet,1974,2(7889):1127-1131.
6. BELKOFF S M, MATHIS J M, JASPER L E, et al.The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior[J]. Spine. 2001;26(14):1537-41.
7. BERLEMANN U, FRANZ T, ORLER R, et al.Kyphoplasty for treatment of osteoporotic vertebral fractures:a prospective nonrandomized study[J].Eur Spine J. 2004;13(6):496-501.
8. PAPADOPOULOS E C, EDOBOROSULA F, GARDNER M J, et al.Unipedicular balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures:early results[J]. J Spinal Disord Tech. 2008;21(8):589-96.
9. STEINMANN J, TINGEY C T, CRUZ G, et al. Biomechanical comparison of unipedicular versus bipedicular kyphoplasty[J]. Spine,2005,30(2):201-205.
10. COTTEN A, DEWATRE F, CORTET B, et al. Percutaneous vertebroplasty for osteolytic metastases and myeloma:effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical followup[J]. Radiology. 1996,200(2):525-30.
11. PHILLIPS F M, PFEIFER B A, LIEBERMAN I H, et al.Minimally invasive treatments of osteoporotic vertebral compression fractures:vertebroplasty and kyphoplasty[J]. Instr Course Lect, 2003,52(3):55967.
12. 孙钢,王晨光.脊柱非血管性介入治疗学[M].济南:山东科学技术出版社,2002:146-156.
13. DIAMOND T H, CLARK W A. Percutaneous vertbroplasty:a novel treatment for acute vertebral fracture[J]. Med J Aust, 2001,174(8):398-400.
14. COTTEN A, BOUTRY N, CORTET B, et al. Percutaneous vertebroplasty:state of the art[J].Radiographics, 1998,18(2):311-20.

West China Medical Journal

Treatment Of Osteoporotic Spinal Compression Fractures by Unipedicular Vertebroplasty

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