三维CT与C型臂X线机引导椎体成形术治疗椎体骨质疏松性骨折的比较分析

摘要

目的 比较分析三维CT与C型臂X线机引导经皮椎体成形术(percutaneous vertebro plasty,PVP)治疗骨质疏松性椎体压缩骨折的疗效和特点.方法 60例骨质疏松性椎体压缩骨折患者随机分成两组,每组30例,分别以三维CT和C型臂X线机引导经皮椎体成形术,记录手术时间、穿刺次数、骨水泥注射量.术前及术后1d进行疼痛视觉类比评分(VAS),测量伤椎高度,随访伤椎高度丢失情况.结果 随访9～24个月,平均13个月.两组患者均无严重并发症发生,术后疼痛视觉类比评分(VAS)、伤椎高度均较术前明显改善,至末次随访仍效果良好.两组术中比较三维CT引导穿刺准确度高,手术时间较短,但骨水泥注射量较C型臂X线机组少.结论 三维CT与C型臂X线机引导经皮椎体成形术疗效无差别,三维CT引导穿刺准确率更高,C型臂X光机引导能够实时监控骨水泥注射过程.%Objective Comparative analysis of the fractures and characteristics of three-dimensional CT and C-arm X-ray machine guided percutaneous vertebroplasty in the treatment of osteo-porotie vertebral compression fractures. Methods 60 patients with osteoporotic vertebral compression fracture were randomly distribute into two groups and three-dimensional CT and C arm X-ray machine guided percutaneous vertebroplasly with operative time,puncture number,bone cement injection amount were recorded. The pain of visual analog scale (VAS),measuring injury vertebral height,vertebral height of loss injury were assessed before and after operation and during follow-up. Results All cases were followed up 9 to 24months,13 months in average. All cases had no severe complications,postoperative pain visual analog scale(VAS) and injury vertebral height were obviously improved. The groups of three-dimensional CT guide had higher puncture accuracy and shorter operative time but less bone cement injection than C arm X-ray groups. Conclusion Three-dimensional CT and C arm X-ray machine guided percutaneous vertebroplasty have the same curative effect,but three-dimensional CT guide puncture higher accuracy and C arm X-ray machine guide can real-time monitor the process of bone cement injection.