局解手术学杂志2025，Vol.34Issue(6)：515-520,6.DOI:10.11659/jjssx.09E024112
三维CT辅助椎弓根测量在老年经皮椎体成形术中的应用研究
Application of three-dimensional CT-assisted pedicle measurement in elderly patients undergoing percutaneous vertebroplasty
摘要
Abstract
Objective To investigate the application effect of three-dimensional CT-assisted pedicle measurement in elderly patients undergoing percutaneous vertebroplasty(PVP).Methods A total of 80 osteoporotic patients with L1 vertebral compression fracture who were treated in People's Hospital of Qujiang District in Shaoguan from March 2021 to March 2023 were selected as the study subjects.Three-dimensional CT-assisted pedicle measurement was performed before surgery,including L1 axial effective angle,axial effective pedicle transverse,oblique sagittal effective angle,oblique sagittal effective longitudinal diameter,and pedicle transverse diameter,and their differences between different genders were analyzed.Four patients with an effective pedicle diameter of less than 3 mm were included into the bilateral group,and the rest of the patients were divided into the unilateral group(received unilateral-approach PVP)and the bilateral group(received bilateral-approach PVP)according to the random number table method.The perioperative conditions of patients in the two groups were collected.The follow-up was performed for six months after surgery,and the visual analogue scale(VAS)score and Oswestry dysfunction index(ODI)score of patients between the two groups were compared before surgery,1 month after surgery and 6 months after surgery.X-ray examinations were performed before and after surgery to evaluate the recovery of Cobb angle and cement leakage.Results No significant difference was observed in axial universal effective angle or universal oblique sagittal effective angles between genders(P>0.05).The male patients showed greater axial lateral effective angle,axial lateral effective pedicle transverse,axial universal effective pedicle transverse,lateral oblique sagittal effective angle,lateral oblique sagittal effective longitudinal diameter,universal oblique sagittal effective longitudinal diameter,and pedicle transverse as compared to female patients,with statistically significant differences(P<0.05).The intraoperative fluoroscopy times and bone cement injection volume of patients in the unilateral group were less/lower than those in the bilateral group,with statistically significant differences(P<0.05).There was no significant difference in the operation time of patients between the two groups(P>0.05).During the follow-up period,3 patients were lost to follow-up in the unilateral group and 4 patients in the bilateral group.One patient in the unilateral group had cement leakage.There were no significant differences in the VAS scores,ODI scores before surgery and 1 month after surgery or Cobb angles before and after surgery between the two groups(P>0.05).The VAS and ODI scores of patients in the unilateral group 6 months after surgery were significantly higher than those in the bilateral group,with statistically significant differences(P<0.05).Conclusion In the treatment of osteoporotic vertebral compression fractures,three-dimensional CT-assisted pedicle measurement before PVP can help to achieve accurate puncture,and improve the safety and effectiveness of the surgery.关键词
CT三维重建/经皮椎体成形术/椎弓根形态/骨质疏松性椎体压缩性骨折/老年Key words
CT three-dimensional reconstruction/percutaneous vertebroplasty/pedicle morphology/osteoporotic vertebral compression fractures/elderly分类
医药卫生引用本文复制引用
蒲鹏吉,黄敏军,敖翔,赖威毅..三维CT辅助椎弓根测量在老年经皮椎体成形术中的应用研究[J].局解手术学杂志,2025,34(6):515-520,6.基金项目
广东省援疆科技(特派员)项目(KTPYJ2021006) （特派员）
