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| Clinical application of unilateral and bilateral approach percutaneous vertebroplasty in senile pathological spinal fractures |
| FAN Liying XUE Jianli CHENG Bin ZHANG Chun WU Hao DONG Jun |
| The Third Department of Orthopedics, the Second Affiliated Hospital of Xi′an Jiao Tong University, Shaanxi Province, Xi′an, 710000, China |
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Abstract Objective To investigate the clinical effect of unilateral and bilateral approach percutaneous vertebroplasty (PVP) in the treatment of senile pathological spinal fractures. Methods A total of 46 vertebral bodies of 38 patients with senile spinal fractures admitted to the Third department of Orthopedics, the Second Affiliated Hospital of Xi′an Jiaotong University from January 2016 to December 2018 and followed up were selected as subjects. According to the random number table method, they were divided into the unilateral approach percutaneous vertebroplasty group (hereinafter referred to as “unilateral group”) and the bilateral approach percutaneous vertebroplasty group (hereinafter referred to as the “bilateral group”), with 23 cases in each group. The operation time and bone cement perfusion volume of the two groups were observed and compared, and the visual analogue score (VAS) and Oswestry dysfunction index (ODI) were recorded and compared before surgery, on the first and second day after surgery, and at the follow-up 6 months after surgery. The efficacy of the patients was evaluated comprehensively. Results The operation time and bone cement injection amount of the unilateral group were significantly less than that of the bilateral group, with highly statistically significant difference (P ＜ 0.01). The difference in time and interaction between the two groups was highly statistically significant (P ＜ 0.01), suggesting that the postoperative efficacy of the two groups was significant, and the efficacy increased gradually with the extension of time. There was no statistically significant difference in interaction between the two groups (P ＞ 0.05), suggesting that there was no significant difference in efficacy between the two groups. Further pairwise comparison showed that 1 d, 2 d and 6 months after surgery were lower than before surgery, 2 d and 6 months after surgery were lower than 1 d and 6 months after surgery were lower than 2 d after surgery, and the differences were highly statistically significant P ＜ 0.01). There was no significant difference in interaction between the two groups at each time point (P ＞ 0.05). Conclusion Unilateral pedicle approach PVP has the advantages of shorter operation time, less radiation damage, less injection of bone cement, and lower treatment cost. However, in the long run, unilateral and bilateral PVP have significant efficacy in the treatment of pathological vertebral compression fractures.
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