张成祺 裴济民 赵永辉

【摘要】 目的 探討单侧弯角穿刺椎体成形术（PCVP）治疗胸腰椎骨质疏松性椎体压缩性骨折（OVCF）的疗效。

方法 采用前瞻性随机试验方法选择2016年3月～2019年12月收治的152例胸腰椎OVCF患者作为研究对象，采用随机数字表分为两组，各76例。观察组行PCVP治疗，对照组常规行双侧经皮穿刺椎体成形术（PVP）治疗。比较两组患者围术期指标及术前、术后3个月的疼痛程度。

结果 观察组手术时间短于对照组，术中出血量、骨水泥注入量及术中X线使用次数少于对照组，差异有统计学意义（P<0.001）;术后3个月，两组患者视觉模拟评分（VAS）均低于术前，且观察组低于对照组，差异有统计学意义（P<0.01）。

结论 与常规双侧PVP相比，PCVP可缩短胸腰椎OVCF患者手术时间，减少术中出血量、骨水泥注射量，减轻患者辐射性损伤及疼痛程度，值得推广。

【关键词】 骨质疏松;椎体压缩性骨折;胸腰椎;单侧弯角穿刺椎体成形术;疼痛程度

中图分类号：R683.2   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2021.04.007

Analysis on curative effect on percutaneous curved vertebroplasty in the treatment of thoracolumbar osteo-porotic vertebral compression fractures

ZHANG Chengqi， PEI Jimin， ZHAO Yonghui

（Department of Orthopedics， The First People's Hospital of Xinxiang， Xinxiang 453000， Henan， China）

【Abstract】 Objective To investigate the efficacy of percutaneous curved vertebroplasty （PVCP） in the treatment of thoracolumbar osteo-porotic vertebral compression fractures （OVCF）.

Methods A prospective randomized trial was used to select 152 patients with thoracolumbar OVCF treated in hospital from March 2016 to December 2019， and random number table was used to divide them into observation group and control group， with 76 cases in each group. The observation group were treated with PVCP， while the control group were treated with routine bilateral percutaneous vertebroplasty （PVP）. And then， perioperative indexes as well as pain degree before operation and 3 months after operation were compared between the two groups.

Results The operation time of the observation group was shorter than that in the control group， and the intraoperative blood loss， bone cement injection volume and intraoperative X-ray use times were less than those of the control group， and difference was significant statistically （P < 0.001）. 3 months after operation， the visual analogue scale （VAS） scores of both groups were lower than those before operation， and that of the observation group was lower than that of the control group， and difference was significant statistically （P < 0.01）.

Conclusion Compared with conventional bilateral PVP， PVCP can shorten the operation time of thoracolumbar OVCF patients， reduce intraoperative blood loss and bone cement injection， alleviate radiation injury and pain degree， which is worthy of promotion.

【Key words】 osteoporosis; vertebral compression fractures; thoracolumbar spine; PCVP; pain degree

骨质疏松性椎体压缩性骨折（osteo-porotic vertebral compression fractures，OVCF）是老年人群常见的骨折类型，临床常采取卧床休息、药物等保守疗法，但治疗时间较长，部分患者依从性较差，治疗效果欠佳[1]。经皮穿刺椎体成形术（percutaneous vertebroplasty，PVP）作为一种微创疗法，可有效改善胸腰椎OVCF患者的临床症状，促进患者身体恢复，已成为胸腰椎OVCF患者首选的手术方法[2]。双侧穿刺及单侧弯角穿刺均为PVP常用穿刺方法，但治疗效果各不相同。本研究旨在比较单侧弯角穿刺椎体成形术（percutaneous curved vertebroplasty，PCVP）与双侧PVP治疗胸腰椎OVCF的疗效，为临床治疗胸腰椎OVCF提供参考，具示如下。

1 资料与方法

1.1 一般资料

采用前瞻性随机试验方法选择2016年3月～2019年12月我院收治的152例胸腰椎OVCF患者作为研究对象，采用随机数字表分为两组，各76例。……