| Objeetive:By percutaneous balloon dilatation of vertebral kyphosis angioplasty for treatment ofsenile fresh osteoporotic vertebral compression fractures, to investigate the treatmentefficacy in clinical application, unilateral approach and bilateral approach to balloondilatation Kyphoplastythe treatment of elderly fresh osteoporotic vertebral compressionfractures differences.Methods:2009-2011, by X-ray balloon dilatation of vertebral kyphosis angioplasty fortreatment of senile fresh osteoporotic vertebral compression fractures38cases, a total of47vertebrae. Patients had obvious chest back pain before surgery, lower extremity sensoryand motor disorders, neurological symptoms. Pre-operative X-rays showed the vertebralwedge compression changes are the changes of osteoporosis. The preoperative CT showedthe vertebral posterior wall integrity and MRI fresh vertebral fractures (T1-weighted imageshows low signal on T2-weighted images showed high signal). Preoperative patients wereprone hyperextended closed reduction under fluoroscopy C-arm fractures, by unilateral orbilateral pedicle puncture vertebral kyphosis forming technique. Surgical unilateral andbilateral pedicle into the posterior percutaneous kyphoplasty grouping.Unilateraltranspedicular approach in21cases (26vertebra),8males and13females, age60-86years,average72.5years old.with a Course of1-15days, both fresh fractures. Fractured vertebralbody was to the T9-L3, with the thoracic12, lumbar spine14. Single vertebral fracture in17cases, double-vertebral fractures in three cases, three vertebral fractures. The averagevertebral height loss of52%. Bilateral pedicle approach group of17cases (21vertebra),9males and8females, age67-81years, mean74years. Duration of1-8days, were freshfractures. Fractured vertebral body of T7-L3, which the thoracic, lumbar spine13. Singlevertebral fracture in14cases, double-vertebral fractures in two cases, three vertebralfractures. The average vertebral height loss of54%.32cases more than one-year follow-up, preoperative and postoperative Japanese Orthopaedic Association (JOA) back paintreatment of disease achievement standard score, visual analog pain score (VAS), activityscore, The standard assessment of the Cobb’s angle measurement, the operating time of therecord of a single vertebral surgery, the bone cement injection volume of hospital stay,complications. And statistical comparative analysisResults:38patients with47vertebral surgery a success. Operation time:45one was65minutes, an average of55min; the Bilateral into the road group80~I10min, an average of95minutes. Perspective views: a single approach group18to29times, an average of23.5times; Double Road group35to48times,41.5times average postoperative low back painwithin24hours were significantly alleviated, unilateral footpath of pain visual analog scale(VAS) before surgery (7.8±1.7) points to postoperative (2.1±1.6) and postoperative (2.7±1.3) points, the bilateral approach of pain visual analog scale (VAS) improved frombefore (7.9±1.6) points to postoperative (2.2persons1.3) points, and postoperative (2.6±1.4) points. The difference between two groups was statistically significant (P>0.05), thetwo groups before and after respective surgery and postoperative follow-up with patientsbefore, the difference was statistically significant (P <0.01). Kyphosis correction of thesituation: unilateral footpath group spine kyphosis Cobb angle before surgery (28.1±5.0°),correction to after (15.6±3.8°), the postoperative follow-up (16.7±4.2°),.; Deformitybilateral approach group kyphosis Cobb angle before surgery (29.2±5.0°) correction toafter (14.7±4.0°), postoperative follow-up (15.8±3.8°). Two sets of their own beforeand after surgery and postoperative follow-up compared with the preoperative, thedifference was statistically significant (P <0.01) between the two groups was no significantdifference (P>0.05). The postoperative anterior vertebral column height than beforesurgery significantly increased, and maintained until the last follow-up, the differenceswere statistically significant (P <0.05). Activity score unilateral improved frompreoperatively to2.87±0.75to1.30±0.34at final follow-up1.43±0.52, bilateralimproved to1.26±0.41preoperatively to2.75±0.83, to the last follow-up was1.39±0.47, before and after surgery, the difference was statistically significant (P <0.05).47of38patients with vertebral surgery a success. Does not appear serious complications ofnerve damage, pulmonary embolism, unilateral approach to group one cases of vertebralside leakage, no clinical symptoms of pain relief. The patients were followed up for6to24months, an average of16months. Surgery vertebral pain got worse and delayed nerveinjury performance and found no operative vertebral height lost. Conclusion:Kyphoplasty has a shorter operative time, less trauma, less bleeding, no significantcomplications and early ambulation, and other advantages.2Kyphoplasty significantlyalleviate the pain caused by senile osteoporosis, vertebral compression fractures, correctionof kyphosis, and significantly improved patient quality of life。 Inevitable link betweenunilateral and bilateral posterior percutaneous pedicle into the vertebral kyphosisangioplasty clinical effects, unilateral pedicle into the path leather kyphoplasty can bebilateral pedicle approach after skin kyphoplasty has the same efficacy, safety andreliability, cost savings can be a wide range of clinical... |
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