刘跃华

[摘要] 目的 应用单侧椎弓根入路和双侧椎弓根入路两种方法完成经皮球囊扩张椎体后凸成形术（PKP）治疗老年胸腰椎压缩性骨折，对2种方法的临床疗效进行比较分析。 方法 该院于2011年9月—2014年8月收治的64例老年胸腰椎压缩性骨折患者按手术入路不同，依次分为A组即采用单侧椎弓根入路者和B组即采用双侧椎弓根入路者，分别以术前术后VAS评分、椎体前缘高度、Cobb角变化作为临床评价指标，用SPSS13.0统计学软件进行统计学分析。 结果 AB各组的术后 VAS评分分别较术前明显降低（P<0.05），椎体前缘高度、脊柱后凸畸形Cobb角术后较术前均明显改善（ P<0. 05）；但A B两组术前术后VAS评分、伤椎前缘高度、Cobb角组间比较，差异无统计学意义（P>0.05）。 结论 临床研究进一步证实采用单侧椎弓根入路完成经皮球囊扩张椎体后凸成形术较双侧椎弓根入路可以获得同样理想的疗效。

[关键词] 胸腰椎压缩性骨折；球囊扩张；椎体成形术

[中图分类号] R687.3 [文献标识码] A [文章编号] 1674-0742（2015）04（c）-0075-03

[Abstract] Objective Comparisons and analysis of the clinical effect between PKP through unilateral and bilateral extrapedicular approach on treating elderly thoracolumbar compression fractures. Methods In our hospital from 2011 September to 2014 August were treated 64 elderly patients with thoracolumbar compression fractures divided into 2 groups according to different surgical approach： A with unilateral extrapedicular approach， B with bilateral extrapedicular approach. Applied preoperative and postoperative VAS score， vertebral height and Cobb angle change as the indexes of clinical evaluation. And the results were analyzed by statistical software SPSS 13.0. Results Postoperative VAS scores are significantly lower than preoperative in both group （P<0.05））； postoperative vertebral height and Cobb angle of kyphosis are obviously improved compared with the preoperative ones（P<0.05）； but comparing the preoperative and postoperative VAS score， the front edge of vertebral height and the Cobb angle between the two groups， the difference was no statistically significant （P>0.05）. Conclusion Clinical studies confirm that compared with PKP through bilateral extrapedicular approach， PKP through unilateral extrapedicular approach can achieve the same desired effect.

[Key words] Vertebral compression fracture； Balloon dilatation； Vertebroplasty

经皮穿刺球囊扩张椎体后凸成形术（PKP）被骨科界认为是治疗老年骨质疏松性椎体压缩骨折的一种理想方法。但手术过程中，究竟是采用单侧椎弓根入路还是实行双侧椎弓根入路仍存在争议。该研究整群选取2011年9月—2014年8月该院收治的64例患者为研究对象，探讨应用这两种入路实施手术的近期疗效，为PKP手术选择更好的入路提供临床依据。

1 资料与方法

1.1 一般资料

整群选取2011年9月—2014年8月该院完成的经皮穿刺球囊扩张椎体后凸成形手术，分别采用单侧椎弓根入路和双侧椎弓根入路两种方法治疗老年胸腰椎压缩性骨折并获随访的64例患者的病例资料进行总结。……