神经导航和X线定位下球囊后凸椎体成形术治疗胸腰椎压缩性骨折

目的分析比较神经导航辅助下和普通C臂X线定位下,经皮球囊扩张后凸椎体成形术(BKP)治疗老年骨质疏松性胸腰椎压缩性骨折的疗效。方法回顾性分析2012年2月-2015年12月收治的38例老年骨质疏松性胸腰椎压缩性骨折的患者,随机采用神经导航定位(18例)和普通C臂X线透视定位(20例)进行BKP。其中单椎体损伤30例,两个椎体损伤8例;骨折位于T1210个,L114个,L26个,L35个,L48个,L53个。患者在神经导航定位下或X线透视下行双侧椎弓根穿刺,受损椎体先用球囊扩张,然后注入骨水泥。术前和末次随访时给患者行疼痛视觉模拟评分(VAS),摄X线片测定椎体前缘压缩程度、椎体后缘压缩程度。结...

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Published in临床神经外科杂志 Vol. 14; no. 5; pp. 369 - 373
Main Author 孙伟;刘卫东;伊藤康信;赵鸿;钱忠心
Format Journal Article
LanguageChinese
Published 上海市浦东新区浦南医院神经外科,上海,200125%南东北总医院脑神经外科 2017
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Summary:目的分析比较神经导航辅助下和普通C臂X线定位下,经皮球囊扩张后凸椎体成形术(BKP)治疗老年骨质疏松性胸腰椎压缩性骨折的疗效。方法回顾性分析2012年2月-2015年12月收治的38例老年骨质疏松性胸腰椎压缩性骨折的患者,随机采用神经导航定位(18例)和普通C臂X线透视定位(20例)进行BKP。其中单椎体损伤30例,两个椎体损伤8例;骨折位于T1210个,L114个,L26个,L35个,L48个,L53个。患者在神经导航定位下或X线透视下行双侧椎弓根穿刺,受损椎体先用球囊扩张,然后注入骨水泥。术前和末次随访时给患者行疼痛视觉模拟评分(VAS),摄X线片测定椎体前缘压缩程度、椎体后缘压缩程度。结果 38例患者的椎体骨水泥注入量为1.5-6.5 ml(平均4.18 ml)。术后随访时间为12-36个月。神经导航组术后VAS评分为(1.62±0.93)分,低于术前的(7.67±1.94)分;椎体前缘压缩程度为(17.81±1.96)%,低于术前的(25.93±2.31)%;差异均有统计学意义(均P〈0.005)。X线定位组VAS评分为(1.83±1.21)分,低于术前的(8.12±0.38)分;椎体前缘压缩程度为(18.27±2.17)%,明显低于术前的(24.87±2.64)%,差异均有统计学意义(均P〈0.005)。结论无论采取神经导航或普通C臂X线下定位,应用BKP治疗老年骨质疏松性胸腰椎压缩性骨折,影像学和临床都会取得满意的效果。
Bibliography:SUN Wei, LIU Wei-dong, ITOHN Yasunobu, et al. (Department of Neurosurgery, Punan Hospital, Pudong New District, Shanghai 200125, China)
neurogation ; X-ray located ; thoracolumbar vertebrae ; balloon kyphoplasty
32-1727/R
Objective To evaluate the effectiveness and the value of balloon kyphoplasty (BKP) in treating aged osteoporosis thoracolumbar vertebrae burst fracture using neuronavigation and C arm X-ray. Methods The clinical data of 38 patients with thoracolumbar vertebrae burst fracture treated with the use of neuronavigation and C arm X-ray by BKP from February 2012 to December 2015 ,were analyzed retrospectively. 46 vertebral bodies were involved, 10 T12, 14 L1 , 6 L2 ,5 L3 ,8 L4and 3 L5 ,including 8 patients of both injured vertebral bodies. BKP through bilateral vertebral pedicles with polymethylmethacrylate was performed at the injection volume of 1.5 - 6.5 ml per vertebral body. Before and after operation, the anterior height and posterior height of fractured vertebral body and the sagittal displacem
ISSN:1672-7770
DOI:10.3969/j.issn.1672-7770.2017.05.012