唐司亚

摘 要 目的：研究单侧与双侧穿刺PVP治疗骨质疏松脊柱骨折的临床效果。方法：选择135例患者，基于穿刺方式分为单侧穿刺组（n=70）和双侧穿刺组（n=65），随访1年，比较手术指标和随访结果。结果：单侧穿刺组手术时间、透视次数、骨水泥量及骨水泥渗漏发生率均低于双侧穿刺组（P<0.05），术后3月伤椎前缘高度较术前升高，椎体后凸Cobb角度较术前降低（P<0.05），术后3月单侧穿刺组VAS评分高于双侧穿刺组（P<0.05）。结论：单侧穿刺PVP治疗能缩短患者手术时间，降低术中透视次数和骨水泥用量，避免骨水泥渗漏的发生。

关键词 经皮椎体成形术 骨质疏松症 脊柱骨折 临床疗效

中图分类号：R683.2 文献标志码：A 文章编号：1006-1533（2021）23-0067-04

A comparative study of unilateral and bilateral puncture with PVP in the treatment of osteoporotic spine fractures

TANG Siya

（Zhengzhou People’s Hospital， Zhengzhou 450000， China）

ABSTRACT Objective： To study the clinical effect of unilateral and bilateral puncture PVP in the treatment of osteoporotic spine fractures. Methods： One hundred and thirty-five patients were selected and divided into a unilateral puncture group （n=70） and a bilateral puncture group （n=65） based on their puncture methods. The follow-up was lasted for 1 year after operation. The surgical indicators and follow-up results were compared between the two groups. Results： The operation time， the number of fluoroscopy， the amount of bone cement and the incidence of bone cement leakage were lower in the unilateral puncture group than the bilateral puncture group （P<0.05）. The height of the anterior edge of the injured vertebrae was increased but the Cobb angle of kyphosis was decreased and VAS scores were higher in the unilateral puncture group than the bilateral puncture group 3 months after operation （P<0.05）. Conclusion： Unilateral puncture PVP therapy can shorten the operation time， reduce the number of intraoperative fluoroscopy and the amount of bone cement and avoid the occurrence of bone cement leakage.

KEY WORDS percutaneous vertebroplasty； osteoporosis； spinal fracture； clinical efficacy

骨质疏松性脊柱骨折是骨质疏松患者最严重的并发症，也是脊柱外科最常见的骨折类型之一，患者以腰背部疼痛、脊柱畸形和功能障碍为主要临床表现，严重者可致残[1]。此类患者治疗可分为非手术治疗和手术治疗，非手术治疗方式要求患者长期卧床，易加剧其骨量丢失和增加再次骨折和脊柱后凸畸形风险，甚至会影响患者肺功能，危及生命[2]。随着微创技术的不断发展，临床治疗此类骨折以手术方式为主，多项报道指出经皮椎体成形术（percutaneous vertebroplasty，PVP）具有手术时间短、创伤小和患者恢复快等优势，目前学界争议的问题在于手术入路的选择[3-4]。本研究通过比较单侧椎弓根穿刺与双刺椎弓根穿刺PVP治疗骨质疏松脊柱骨折患者的临床效果，分析不同手术入路对患者手术和临床效果的差异，为今后此类患者治疗提供一定的依据。……