| Objective:To compare the clinical efficacy between bipedicular approach andextrapedicular approach of percutaneous vertebroplasty in the treatment of thoracicosteoporotic vertebral compression, provide the basis for operation choice in the cases ofthoracic osteoporotic vertebral compressionMethods:Totally50patients of thoracic osteoporotic vertebral compression fracturesoperated by vertebroplasty from June2011to January2013were retrospectively analyses.50patients were divided into2groups randomly, according to number of patients. odd numberof patients that defined as unilateral group implement extrapedicular approach ofpercutaneous vertebroplasty, even number of patients that defined as bilateral groupimplement bipedicular approach of percutaneous vertebroplasty. All of them received morethan one years’ follow-up. The visual analogue scale (VAS) and ODI scores were evaluated3-day preoperative and at12-month after operation. vertebral compression rate was observedby imaging data. And evaluate the surgical time, bone cement injection, perspective times,bone cement leakage in the perioperative period. Statistic difference was checked with SPSS17.0Results:Among the50cases of patients,42cases were followed up,8cases were lost. Inunilateral group, the date of average surgical time, bone cement injection,perspective timeswere (31.4±6.8）min,(3.0±0.3）ml,(18.7±2.6）times. The VAS was reduced to (2.7±0.6) after3days from (7.7±0.5) preoperatively, and was (1.4±0.4) after1years’follow-up. ODI scores reduced to（29.4±4.6）after3days from（81.7±5.2）preoperatively, and was（25.6±3.2）after1years’follow-up. The preoperative of vertebral compression ration was (32.3±6.8)%, after3days and1year, respectively vertebral compression ratio was (23.1±9.5)%and (23.7±7.2)%.In bilateral group, the date of average surgical time, bone cement injection,perspective timeswere (48.6±6.7）min,(3.0±0.5）ml,(27.8±4.3）times. The VAS was reduced to (2.6±0.5)after3days from (7.6±0.6) preoperatively, and was (1.2±0.3)after1years’follow-up. ODIscores reduced to（29.1±5.2）after3days from (80.9±6.6) preoperatively, and was（25.1±4.0）after1years’follow-up. The preoperative of vertebral compression ration was（31.3±7.3）%,after3days and1year, respectively vertebral compression ratio was（22.4±6.4）%and（22.9±5.7）%.Compared with these two groups, the surgical time and the perspective timeswere statistical significance differences(P <0.05); the bone cement injection between thesetwo groups were no statistical significance differences(P>0.05); Compared within eachgroup,the preoperative and postoperative of VAS and ODI scores and vertebral compressionration were statistical significance differences(P<0.05), while the postoperative3days andthe1years’follow-up were no statistical significance differences(P>0.05). The recovery rateof VAS and ODI scores and vertebral compression ration between these two groups were nostatistical significance differences(P>0.05). There was2case occured cement leakage in thedisc in the unilateral group, and there were3cases occurred cement leakage in the bilateralgroup, which were located in the paravertebral venous plexus, disc and front vertebral.There was no case of pulmonary embolism,cerebral embolism, spinal cord or nerve rootinjury and other complications. A mean follow-up postoperatively is1years. There is noalleviate pain in the injured vertebral body. The injured vertebral body height recovered betterthan preoperation,without significant further compression.Conclusion: Extrapedicular approach vertebroplasty can not only achieve the sameresults of bipedicular approach vertebroplasty in the treatment of thoracic osteoporoticvertebral compression fractures, but also has the advantages of shorter surgical time, less radiation exposure, less trauma, and lower cost, so extrapedicular approach vertebroplasty is asafe, practical and effective method in the treatment of thoracic osteoporotic vertebralcompression fractures, considered for clinical. |
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