The Application Of Percutaneous Vertebralplasty And Kyphoplasty In Minimal Invasive Spinal Surgery

Objective:To explore the effect of unipedicular or bipedicular approach to percutaneous vertebralplasty and kyphoplasty in treatment of osteoporotic vertebral fracture and metastatic vertebral tumor.Methods:56cases (68quarter vertebral) vertebral compression fracture patients, the disease for osteoporosis (48cases) and spinal vertebral transfer tumor (8cases) cause compression fractures, are all fresh fractures, less than2weeks, and physical change related spinal tenderness, percussion pain, low back pain, change positions pain worse and abdominal pressure of the pain from high aggravated, no spinal nerve root compression symptoms. This group of56cases, male,24cases were32cases of female, age50to78years. Injury vertebral segment involvement T106sections, T1110sections,T1220sections. L118sections, L210sections,L34sections. The unipedicular approach of30cases of36vertebral, bipedicular approach of26cases of32vertebral. Directly injecting into bone cement (PMMA)50cases, percutaneous kyphoplasty6cases.Results:For this experiment of56cases obtained the patients were complete follow-up data. Two groups of surgical approach each observation of the index is both not related serious complications (such as bone cement infiltration rate the<15%) and clinical visible of the serious adverse events. Unipedicular approach group:operation time20-54(32.6±11.6) minutes, injection bone cement2.5-4.6(3.0±0.8) ml/section; Bone cement leakage5cases, all happened in the leakage of soft tissue. Bipedicular approach group:operation time30to60(42.5±10.3) minutes; Injection of bone cement3.2-5.5(4.0±0.8) ml/section; Bone cement leakage3cases,2cases the leakage of soft tissue.1case the leakage of intervertebral disc space.Leakage often appeared of fever, but self-limiting, did not cause the corresponding nervous symptoms and pulmonary embolism, etc. The One-way variance analysis, evaluation all patients Visual Analogue Score (VAS), vertebral recovery after injury height and Cobb horn. After one week and after one year pain (VAS) were improved significantly (P<0.05), two kinds of approaches, the method is1week and after one year (VAS) score no significant difference (P>0.05); Two approaches for recovery height and Cobb Angle is significant difference (P<0.05), unipedicular or bipedicular approach compared to recovery height and Cobb Angle was no statistically significant (P>0.05).Conclusion:In the PVP and PKP,unipedicular or bipedicular approaches can significantly reduce the patients with pain which caused by osteoporosis and metastatic vertebral tumor vertebral compression fracture.two into the approach comparison, after one week and after one year pain score difference was statistically significant; In the recovery of vertebral height and Cobb Angle of the injury vertebral is significant, but unipedicular or bipedicular approach compared to recovery height and Cobb Angle was no statistically significant.