The Related Research Of Clinical Efficacy And Safety Of Unilateral Percutaneous Vertebroplasty For Thoracolumbar Vertebral Compression Fracture

Objective: To investigate the puncture technique,efficacy and safety of unilateral percutaneous vertebroplasty in the treatment of elderly thoracolumbar vertebral compression fractures.Methods: Eighty elderly patients during December 2016 to June 2018 with osteoporotic thoracolumbar vertebral compression fractures underwent unilateral puncture vertebroplasty under individualized puncture strategy,the average age is 67.25±6.46.Under constant external conditions,the patients were divided into group A,group B,group C,group D,and group E according to the initial bolus moments with fixed ratio of solvent to solute(volume ratio 1:1).Group C is the central group of traditional empirical initial bolus moments(4min)according to the above fixed proportion of cement mixing,and the other groups is formed before or after the initial bolus time for 30 s,group A(3min),group B(3.5min),group D(4.5min),group E(5min),16 patients in each group,follow the principle of random distribution.The VAS score and ODI score and bone cement leakage in group A(3min),group C(4min),group B(3.5min),group D(4.5min),and group E(5min)in the different period of Preoperative and post-operative,adjacent vertebrae refracure and other indicators are counted separately.Compare the differences of cement dispersion area、bone cement leakage rate in each group and post-operative,adjacent vertebrae refracure rate,and then find the optimal bone cement starting moment,and make a more accurate description of the cement state at that moment.Statistical analysis was performed using SPSS 22.0 statistical software.The data were expressed as mean ± standard deviation(x ± s)and analyzed by t test.Results: The average operation time was 20±4.5min.The average number of transmissions of the X-ray machine was 16.5±3.5 times,and the bone cement dispersion was biased toward the puncture side.The amount of bone cement single vertebral injection was 6.50±1.63 ml.,The average puncture angle α is 30±4.5°.The preoperative and postoperative different indexes were compared.After statistical analysis,the difference was statistically significant(p<0.05),and the incidence of bone cement leakage was 16.25%.Under the same external conditions,when the bone cement can be pushed out in a column shape and can not resist gravity(D group),the bolus injection can achieve satisfactory dispersion and less cement leakage.Conclusion:(1)Unilateral puncture can significantly improve the success rate of puncture through preoperative measurement and design.(2)The unilateral puncture of the vertebroplasty in the treatment of the senile osteoporotic thoracolumbar compression fracture has some defects,but the curative effect is exact,the wound is small,the safety is safe and reliable,it is a recommended clinical treatment means.(3)The bone cement can be pushed out in a cylindrical shape and the moment of irresistible gravity is the best starting moment for bone cement.