单侧经皮穿刺脊柱后凸椎体成形术的入路探讨.docVIP

单侧经皮穿刺脊柱后凸椎体成形术的入路探讨 作者：石化洋，何睿，马红兵，陈玲，胡明鉴，曾勇 作者单位：成都市第二人民医院骨科，四川 成都 【摘要】 目的 探讨单侧穿刺法行脊柱后凸成形术的手术方法，以减少行手术及射线时相关的损害。方法 复习椎骨的解剖形态，确定经椎弓根穿刺进针的路径；对患者45个压缩椎体进行单侧穿刺球囊扩张治疗，观察椎体高度及Cobb角的改变。结果 与椎骨矢状面成30°～45°的角度穿刺，均能顺利进针并使针尖到达椎体中部的前份；临床手术按前述方法均可安全完成，椎体前缘、中部高度及Cobb角分别由术前的(1.8±0.3) cm、(1.4±0.4) cm及(28.4±10.2)°改变为术后的(2.2±0.4) cm、(2.3±0.3) cm及(19.2±4.5)°；椎体两侧前缘高度都有所恢复，两侧高度净差值为0.1 cm。结论 单侧穿刺法行脊柱后凸成形术，能够很好地恢复脊柱的形态，减少术者及患者的射线接触。 【关键词】 椎体；压缩骨折；经皮脊柱后凸成形术；单侧穿刺 Percutaneous Kyphoplasty：the Primary Exploration of Unilateral Puncture Surgical Approach and Clinical Application SHI Huayang，HE Rui，MA Hongbing，et al (Department Of Orthopaedics，The 2nd People′s Hospital of Chengdu，Chengdu 610017，China) Abstract：Objective The primary exploration of unilateral puncture surgical approach to procedure kyphoplasty safely.Methods Review the anatomy of vertebrae to determine the pathway of pins by unipedicle.After Surgical intervention of forty five vertebral compression fractures by unilateral kyphoplasty，the changes of height and Cobb angle of vertebral bodies were investigated.Results Sagittal plane into the vertebrae and 30°～45° angle puncture needle can successfully make the needle reach the central anterior vertebrae.All surgical procedures were completed safely.The mean height of the anterior and media vertebral bodies was 1.8±0.3 cm，1.4±0.4 cm preoperatively and2.2±0.4 cm、2.3±0.3 cm postoperatively；the Cobb angle was decreased from 28.4±10.2° preoperatively to 19.2±4.5° postoperatively.The mean absolute value of the difference in height between right and left side of the vertebral bodies was 0.1 cm in this group.Conclusion The kyphosis is improved and the operative time is reduced by unilateral kyphoplasty obviously.Though this result is satisfied，more clinical studies are needed to be done for authenticating the efficacy of unilateral kyphoplasty on the treatment of vertebral compression fractures in the future. Key words：vertebral；compression fractures；kyphoplasty；un