| Objective: Osteoporosis (Osteoporosis) is to The phalanx mineralsand bone in proportion to constantly reduce the clinical corticalthinning, reduce the number of pathological features of trabecularbone brittle increase and easy concurrent fracturekinds ofsystemic bone metabolism disorders. Lower back pain is the mostcommon clinical manifestations of pain along the spine to theboth sides of the diffusion supine pain relief, extension orlong-established pain got worse: fracture degenerativeosteoporosis is the most common and most serious complications,sub-chestsegment, lumbar, thoracolumbar, and diffuse spinal pain,seriously affecting the quality of life of patients. With the rapiddevelopment of modern medical technology, percutaneousvertebral kyphosis angioplasty has become the preferred methodof today’s treatment of osteoporotic compression fractures,minimally invasive surgical methods and significant analgesiceffects were widely accepted, and it clinical rapidly launch.Compressed vertebral body through unilateral or bilateral pedicleways percutaneous vertebral kyphoplasty whether there aredifferences in the clinical effects, many experts and scholars toexpress their views, not reached a consensus. This study bilateral kyphoplasty (PKP) the effect of contrast, single vertebral column,to analyze whether there are differences of two surgical methods,into the road Percutaneous balloon dilatation of unilateral andbilateral vertebral kyphoplasty (PKP) in the treatment ofosteoporotic thoracolumbar vertebral compression fractures,clinical observations, analysis of the differences of the two surgicaloperations.Materials and Methods: Retrospective analysis of himself admittedin Hubei Province Traditional Chinese Medicine Hospitalorthopedic internship period (2010.10-2012.12) take PKPtreatment of osteoporotic thoracolumbar compression fracture ofthe55patients (35women,20men patients), press of differentsurgical approach, were randomly divided into the the unilateralapproach PKP group and bilateral approach PKP group. unilateralapproach road PKP group of30patients, bilateral approach PKPgroup of25patients, aged56-92years old, the average age of76.4years of age, all patients were successfully operated under theC-arm X-ray machine, have received more than1year of follow-up,the two groups were compared in the pain simulation symptomsVAS score, vertebral kyphosis activity score (MDS), surgerytime,intraoperative bone differences in the amount of cement, cementleakage.Results:Pain the simulation symptoms VAS Rating:The the unilateral approach PKP Group: preoperative VASscores of24hours (7.73±1.35) minutes,24hours after the VASscore (3.12±1.49) points after January VAS score (3.03±1.48)points; surgery VAS scores before and after comparison was statistically significant (p <0.01),24hours after surgery andpostoperative VAS score was not statistically significant (p>0.05).The the bilateral approach PKP Group:24hours before surgery(7.63±1.43) points, after24hours (2.33±0.99) points,after1month (2.10±0.19) points, before and after surgery wasstatistically significant (p <0.01), a week after surgery and aftersurgery in month, compared to June was not statisticallysignificant (p>0.05).Spinal dysfunction scoreThe unilateral approach PKP group postoperative Oswestryscore was11.52±1.49. Postoperative Oswestry score the bilateralapproach PKP group was11.27±1.98. The two sets ofdysfunction index was not statistically significant (t=0.567, p>0.05).Surgery duration comparison:Unilateral approach PKP group operative time (50.82±6.17)minutes. Bilateral approach PKP group operative time (60.93±5.65) minutes. The operation time of the two groups wasstatistically significant (t=6.762, p <0.01).The intraoperative bone cement consumption comparison:Amount of bone cement the unilateral approach PKP in group(2.96±0.92) ml. The bilateral approach PKP group intraoperativebone cement consumption (3.79±0.98) ml. Two sets ofintraoperative bone cement consumption was statisticallysignificant (t=3.490, p <0.01).Vertebral kyphosis comparison:The unilateral approach PKP group preoperative (16.36±4.05)°, and24hours after (13.52±2.75)°, after1month (13.57 ±2.71)°. Statistically significant (p <0.01) before and after thesurgery,24hours after surgery and postoperative Januarycomparison was not statistically significant (p>0.05). Bilaterallyinto the road PKP group surgery (15.89±3.72)°,24hours aftersurgery (13.63±2.73)°, after1month (13.65±2.72)°.Statistically significant (p <0.05) before and after the surgery,24hours after surgery and postoperative January comparison wasnot statistically significant (p>0.05). Between the two groupsbefore and after surgery was not statistically significant (p>0.05).Bone cement leakage:The unilateral approach PKP group of33patients, three casesof leakage, the rate was9.09percent. The bilateral approach PKPgroup of30patients, the leak rate of3.33%. The two sets ofperfusion agent leakage was statistically significant (X2=0.88, p<0.05).Conclusion: unilateral or bilateral approach PKP surgery cansignificantly alleviate the osteoporotic thoracolumbar vertebralcompression fractures caused by the symptoms, and the partialrestoration of spinal kyphosis, which can effectively improve thefunction of the patient’s spine. Unilateral or bilateral approach thePKP treatment of osteoporotic vertebral compression fracturessimilar clinical efficacy, however, the unilateral approach PKPgroup can significantly shorten the operation time, reduce theamount of bone cement; the bilateral approach PKP group thanunilateral approach PKP group cement leakage rate is slightly low;reasonable puncture clinical should be selected depending on thepatient. |
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