UTPP及UTP入路PVP治疗老年胸腰椎OVCF的临床特点

doi:10.3969/j.issn.1007-3205.2025.04.005

河北医科大学学报 ›› 2025, Vol. 46 ›› Issue (4): 400-405.doi: 10.3969/j.issn.1007-3205.2025.04.005

UTPP及UTP入路PVP治疗老年胸腰椎OVCF的临床特点

1.河北省邯郸市中心医院骨科,河北邯郸 056001；2.河北省邯郸市中心医院影像科,河北邯郸 056001

出版日期:2025-04-25 发布日期:2025-04-17
作者简介:袁宇飞（1985-)，男，河北邯郸人，河北省邯郸市中心医院副主任医师，医学硕士，从事骨科疾病诊治研究。
基金资助:
河北省医学科学研究课题计划（20231958）

Clinical features of UTPP-PVP and UTP-PVP in the treatment of thoracolumbar OVCF in the elderly

1.Department of Orthopedics, Handan Central Hospital, Hebei Province, Handan 056001, China；
2.Deparment of Imaging, Handan Central Hospital, Hebei Province, Handan 056001, China

Online:2025-04-25 Published:2025-04-17

摘要/Abstract

摘要： 目的探讨经单侧横突-关节突入路（unilateral transverse process-pedicular，UTPP）椎体成形术（percutaneous vertebroplasty,PVP）治疗老年胸腰椎骨质疏松性压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床效果。
方法收集2019年10月-2022年10月于河北省邯郸市中心医院骨科住院治疗的老年胸腰椎OVCF患者156例的临床资料。根据手术入路不同将患者分为UTPP组和单侧椎弓根入路（unilateral transpedicular,UTP）组，比较2组手术时间、骨水泥注入量、骨水泥分布优秀率、骨水泥渗漏率。比较2组术前、术后1 d、术后1个月、术后1年的视觉模拟疼痛（visual analogue scale,VAS）评分和Oswestry功能障碍指数（Oswestry disability index,ODI）评分。比较2组术前、术后1 d、术后1年椎体前缘高度、Cobb角。
结果 2组手术时间差异无统计学意义［UTPP组（48.38±3.55)min、UTP组(48.59±3.50)min，P＞0.05］;UTPP组骨水泥注入量［（5.03±0.63)mL］大于UTP组［（4.11±0.51）mL］，骨水泥分布优良率(92.96%)高于UTP组（61.18%），骨水泥渗漏率(7.04%)小于UTP组（18.82%）,差异有统计学意义（P＜0.05）。随时间推移，2组VAS评分和ODI评分均呈降低趋势，时点间、组间·时点间交互作用差异有统计学意义（P＜0.001），组间差异无统计学意义（P＞0.05）。术后1 d和术后1年，2组椎体前缘高度高于术前，Cobb角低于术前，时点间差异有统计学意义（P＜0.001），组间、组间·时点间交互作用差异无统计学意义（P＞0.05）。
结论 UTPP-PVP可以实现单侧入路双侧弥散，骨水泥分布均匀，术后患者胸腰椎疼痛减轻、功能恢复良好可实现早期下地。

关键词: 脊柱骨折, 骨质疏松, 椎体成形术, 横突-关节突入路

Abstract: Objective To investigate the clinical effectiveness of unilateral transverse process-pedicular percutaneous vertebroplasty (UTPP-PVP) in the treatment of thoracolumbar osteoporotic vertebral compression fracture (OVCF) in the elderly.
Methods The clinical data of 156 elderly patients with thoracolumbar OVCF who were hospitalized in the Department of Orthopedics of Handan Central Hospital from October 2019 to October 2022 were collected. Based on different surgical approaches, the patients were divided into UTPP group and unilateral transpedicular (UTP) group, and the duration of operation, bone cement injection volume, excellent rate of bone cement distribution and bone cement leakage rate were compared between the two groups. The visual analogue scale (VAS) scores and Oswestry disability index (ODI) scores were compared between the two groups before surgery, at 1 d, 1 month and 1 year after surgery. The anterior vertebral body height and the Cobb angle were compared between the two groups before surgery, and at 1 d and 1 year after surgery.
Results There was no significant difference in duration of operation between the UTPP group and the UTPP group ［(48.38±3.55) min vs. (48.59±3.50) min, P＞0.05］, the cement injection volume was greater than that of the UTP group ［(5.03±0.63) mL vs. (4.11±0.51) mL］, the excellent distribution rate of bone cement was higher than that of the UTP-PVP group (92.96% vs. 61.18%), and the leakage rate of bone cement was significantly lower than that of the UTP group (7.04% vs. 18.82%,P＜0.05). Over time, both VAS scores and ODI scores showed a decreasing trend, with significant differences in the interaction between time points and time points between groups (P＜0.001), but no significant differences between groups (P＞0.05). At 1 d and 1 year after surgery, the anterior vertebral body height of both groups was higher than that before surgery, and the Cobb angle was lower than that before surgery, with significant differences in interaction between time points (P＜0.001). However, there was no significant difference in the interaction between groups and time points between groups (P＞0.05).
Conclusion UTPP-PVP can ensure unilateral diffusion and bilateral diffusion as well as uniform distribution of bone cement, and early off-bed activity can be achieved with reduced thoracolumbar pain and good functional recovery after surgery.

Key words: spinal fractures, osteoporosis, vertebroplasty, transverse process-pedicular approach

袁宇飞1, 樊凯彬1, 张存1, 何娟1, 李健斐2, 苗洁1. UTPP及UTP入路PVP治疗老年胸腰椎OVCF的临床特点[J]. 河北医科大学学报, 2025, 46(4): 400-405.

YUAN Yu-fei1, FAN Kai-bin1, ZHANG Cun1, HE Juan1, LI Jian-fei2, MIAO Jie1. Clinical features of UTPP-PVP and UTP-PVP in the treatment of thoracolumbar OVCF in the elderly[J]. Journal of Hebei Medical University, 2025, 46(4): 400-405.

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UTPP及UTP入路PVP治疗老年胸腰椎OVCF的临床特点

Clinical features of UTPP-PVP and UTP-PVP in the treatment of thoracolumbar OVCF in the elderly

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