目的:探討單側(cè)經(jīng)椎弓根基底部外側(cè)穿刺進(jìn)針的可行性和安全性。方法:14例椎體壓縮性骨折經(jīng)椎弓根基底外側(cè)穿刺進(jìn)針,球囊擴(kuò)張,骨水泥注入治療,使用VAS評(píng)分法評(píng)價(jià)患者疼痛變化,測(cè)定手術(shù)前后椎體前、中柱高度與Cobb角。結(jié)果:單側(cè)經(jīng)椎弓根基底外側(cè)穿刺的手術(shù)均安全完成。VAS評(píng)分由術(shù)前平均(8.5±0.3)分改善到術(shù)后(2.2±0.2)分,隨訪三月為(2.1±0.4)分 (與術(shù)前比較,P lt;0.05); 椎體前緣高度由術(shù)前(13.6±2.3) mm到術(shù)后(24.5±2.2) mm,隨訪三月為(24.3±2.0) mm(與術(shù)前比較,P lt;0.05);錐體中部高度由術(shù)前(14.2±2.1) mm到術(shù)后(25.6±2.4) mm,隨訪三月為(25.4±2.2) mm(與術(shù)前比較,P lt;0.05); Cobb角由術(shù)前的(22.5±3.6)°到術(shù)后(10.5±3.0)°隨訪三月為(10.3±2.8)°(與術(shù)前比較,P lt;0.05)。結(jié)論:經(jīng)椎弓根基底外側(cè)的單側(cè)穿刺錐體成形術(shù)可有效恢復(fù)骨質(zhì)疏松性椎體壓縮性骨折椎體高度、緩解疼痛,是一種安全、有效的治療方法,值得推廣。
引用本文： 余彬,陳勤,鄧寧. 單側(cè)經(jīng)椎弓根基底外側(cè)穿刺治療胸腰段椎體壓縮性骨折. 華西醫(yī)學(xué), 2009, 24(7): 1673-1675. doi: 復(fù)制
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| 3. | PEH W C, GILULA L A. Percutaneous vertebroplasty:indications, 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:1year 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 nonrandomized study[J].Eur Spine J. 2004;13(6):496-501. |
| 8. | PAPADOPOULOS E C, EDOBOROSULA 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 followup[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):55967. |
| 12. | 孫鋼,王晨光.脊柱非血管性介入治療學(xué)[M].濟(jì)南:山東科學(xué)技術(shù)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,楊定焯,張祖君,等.骨質(zhì)疏松性脊椎壓縮性骨折流行病學(xué)調(diào)查分析[J].中國(guó)骨質(zhì)疏松雜志, 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:indications, 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:1year 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 nonrandomized study[J].Eur Spine J. 2004;13(6):496-501.
- 8. PAPADOPOULOS E C, EDOBOROSULA 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 followup[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):55967.
- 12. 孫鋼,王晨光.脊柱非血管性介入治療學(xué)[M].濟(jì)南:山東科學(xué)技術(shù)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.