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

蒲鹏吉; 黄敏军; 敖翔; 赖威毅

doi:10.11659/jjssx.09E024112

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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

临床研究 | 更新时间：2025-06-17

- 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
- 局解手术学杂志 2025年34卷第6期页码：515-520
- 作者机构：
  
  1.南方医科大学第三附属医院脊柱外科，广东广州 510000
  2.韶关市曲江区人民医院骨科，广东韶关 512000
  3.南方医科大学南方医院脊柱外科，广东广州 510000
- 作者简介：
  
  黄敏军，E-mail，hmjlceb@163.com
- 基金信息：
  
  广东省援疆科技（特派员）项目(KTPYJ2021006)
- DOI：10.11659/jjssx.09E024112
  中图分类号： R683.2
- 收稿日期：2024-09-20，
  
  纸质出版日期：2025-06-25
- 稿件说明：
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蒲鹏吉,黄敏军,敖翔等.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(06):515-520.

PU Peng-ji,HUANG Min-jun,AO Xiang,et al.Application of three-dimensional CT-assisted pedicle measurement in elderly patients undergoing percutaneous vertebroplasty[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(06):515-520.
蒲鹏吉,黄敏军,敖翔等.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(06):515-520. DOI： 10.11659/jjssx.09E024112.

PU Peng-ji,HUANG Min-jun,AO Xiang,et al.Application of three-dimensional CT-assisted pedicle measurement in elderly patients undergoing percutaneous vertebroplasty[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(06):515-520. DOI： 10.11659/jjssx.09E024112.

摘要

目的

探讨三维CT辅助椎弓根测量在老年患者经皮椎体成形术（PVP）中的应用效果。

方法

选取2021年3月至2023年3月在韶关市曲江区人民医院就诊的80例骨质疏松性L

椎体压缩性骨折患者为研究对象，术前进行三维CT辅助椎弓根测量，包括L

轴位有效角度、轴位有效椎弓根横径、斜矢状位有效角度、斜矢状位有效纵径、椎弓根峡部横径，并分析其在不同性别间的差异。将4例患者有效椎弓根横径小于3 mm纳入双侧组，其余患者按照随机数字表法分为单侧组（行单侧入路PVP）及双侧组（行双侧入路PVP）。统计2组患者围术期情况。术后随访6个月，比较2组患者术前、术后1个月、术后6个月视觉模拟量表（VAS）评分及Oswestry功能障碍指数（ODI）评分。手术前后进行X射线检查评估Cobb角恢复情况及骨水泥渗漏情况。

结果

双侧轴位有效角度、双侧斜矢状位有效角度在性别上差异无统计学意义（

0.05）；男性患者单侧轴位有效角度、单侧轴位有效椎弓根横径、双侧轴位有效椎弓根横径、单侧斜矢状位有效角度、单侧斜矢状位有效纵径、双侧斜矢状位有效纵径、椎弓根峡部横径均大于女性，差

异有统计学意义（

0.05）。单侧组患者术中透视次数少于双侧组，术中骨水泥注入量低于双侧组，差异均有统计学意义（

0.05）；2组患者手术时间比较，差异无统计学意义（

0.05）。随访期间单侧组患者3例失访，双侧组4例失访。仅单侧组有1例患者出现骨水泥渗漏。2组患者术前及术后1个月VAS、ODI评分及手术前后Cobb角比较，差异均无统计学意义（

0.05）；术后6个月单侧组患者VAS、ODI评分均高于双侧组，差异有统计学意义（

0.05）。

结论

在行PVP治疗骨质疏松性椎体压缩性骨折时，术前使用三维CT辅助椎弓根测量，有助于精准穿刺，提高手术的安全性及有效性。

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 L

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 L

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（

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 （

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（

0.05）. There was no significant difference in the operation time of patients between the two groups （

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 （

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 （

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

Keywords

references

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