| Objective: To investigate the safety and effectiveness of treatment of osteoporotic vertebral ompression fracture(OVCF) by percutaneous kyphoplasty(PKP) with photoelectric navigation. Methods: November 2012 to September 2014, the fourth people’s hospital of Zigong City orthopedics admitted 63 cases of OVCF(82 vertebral) by PKP with photoelectric guided. male 12, female 51, between the ages of 61 and 85, average 71.2. Divided into 2 groups according to navigation mode. The test group: 32 cases(43 vertebral) by individual puncture PKP with photoelectric guided, male 6, female 26, ages 62 to 86, average 71.7; The control group: 31 cases(39 vertebral) by PKP undergone C arm X-ray perspective, male 6, female 25, ages 61 to 86, average 70.8. There were no significant difference in the physical data of sex, age, pathogeny, VAS score and vertebrae distribution between the two groups in preoperative(P>0.05). Both groups were evaluated pain by VAS score before and after surgery, recorded cases of successful unilateral puncture, X-ray exposure frequency, number of puncture and operation time in intraoperative, observed pedicle breakthrough and cement leakage at X-ray and CT films, recorded vascular, nerval, cerebrospinal fluid leakage and other related complications in postoperative, dispose them in statistical. Results: 0 case of pedicle breakthrough and 1 cases of cement leakage in test group, 2 cases of pedicle breakthrough and 5 cases of cement leakage in control group, there were no vascular, nerval, cerebrospinal fluid leakage and other related complications occurred in postoperative. To compared the VAS score at 24 hours after operation between the two groups, the difference has no statistically significant(P>0.05), the comparison of corresponding index with the preoperative in each group has statistical significance(P<0.05). Intraoperative the test group had lower X-ray exposure frequency and number of puncture than control group(P<0.05), and operation time difference showed no significance between two groups(P>0.05). Intraoperative successful unilateral puncture rate of test group was better than that of control group(P<0.05). The related complication incidence, such as pedicle breakthrough, cement leakage, vascular, nerval, cerebrospinal fluid leakage and other complications, of test group were obviously lower than that of control group(P<0.05). Conclusion: In the treatment of OVCF by individual puncture PKP with photoelectric guided, unilateral puncture can achieve the purpose of traditional bilateral puncture. The operation time of test group was not significantly different from the control one, there was no increase in the workload of patients and patients tolerance time, therefore this method had better clinical effect. During the individual puncture with photoelectric guided, successful unilateral puncture rate and puncture times were better than control group, and puncture accuracy improved significantly. The rates of X-ray exposure, pedicle breakthrough and cement leakage were lower compared with control group, had no vascular, nerval, cerebrospinal fluid leakage and other complications occurred, so this method had higher security. The determination of puncture camber angle could be more exactly by photoelectric navigation system, that could judged according to the distance scale of cursor extended line on navigation screen, thus reduced the error brought by orthopedist feel, experience and patients position in PKP with the C arm X-ray perspective. |
PDF Full Text Request