关键词:

胸腰椎压缩性骨折, 单侧拐角穿刺, 椎体成形术, 骨水泥

Abstract:

Objective　To compare the clinical outcomes of traditional unilateral or bilateral straight needle puncture vertebroplasty and unilateral corner puncture vertebroplasty in the treatment of thoracolumbar osteoporotic vertebral compression fractures (OVCFs). Methods　It was a randomized controlled trial. A total of 150 patients with OVCFs were diagnosed in Yiyang Central Hospital from November 2017 to December 2020. There were 66 males and 84 females; aged 65-92 years, with an age of (70.3±6.2) years old. They were divided into a unilateral straight needle puncture group, a bilateral straight needle puncture group, and a unilateral corner puncture group by the random number table method with 50 patients in each group. The operation time, radiation exposure time, intraoperative blood loss, postoperative first ambulation time, bone cement injection amount, bone cement distribution in the vertebral body, and Visual Analogue Scale (VAS) scores and Oswestry Disability Index (ODI) 1 month and 3 months after surgery were compared among the three groups. χ² test, rank sum test, and t test were used. Results　The operation time, radiation exposure time, intraoperative blood loss, and postoperative first ambulation time of the unilateral corner puncture group were all lower than those of the traditional unilateral or bilateral straight needle puncture group [(34.30±5.60) min vs. (58.26±4.34) min and (64.30±5.60) min, (5.28±2.21) min vs. (10.70±3.63) min and (15.98±4.20) min, (20.30±2.53) ml vs. (32.06±4.30) ml and (36.72±3.40) ml, (2.03±1.30) d vs. (3.54±4.17) d and (3.71±2.14) d], the bone cement distribution in the vertebral body was better than those of the traditional unilateral or bilateral straight needle puncture group, with statistically significant differences (all P<0.05). There was no statistically significant difference in the bone cement injection volume among the three groups (P>0.05). The VAS scores and ODI of the three groups 1 month and 3 months after surgery were significantly lower than those before surgery (all P<0.05), but there were no statistically significant differences among the three groups (all P>0.05). Conclusions　Unilateral corner puncture vertebroplasty may be beneficial to the patients' early postoperative rehabilitation compared with traditional straight needle puncture vertebroplasty. Long-term follow-up studies involving large sample are needed to further confirm our findings in order to support the clinical promotion of this technology.

Key words:

Thoracolumbar vertebral compression fractures, Unilateral corner puncture, Vertebroplasty, Bone cement