Objective For patients with osteoporotic vertebral compression fractures(OVCF)undergoing unilateral percutane-ous kyphoplasty(PKP),a preoperative computer-aided design(CAD)of the puncture pathway is based on 3D-CT imaging.This study explores the feasibility and effectiveness of such preoperative designs through clinical practice.Methods A retrospective case-control study was conducted,including an analysis of 31 patient samples and completing 42 vertebral surgeries using unilateral ap-proach PKP.Preoperative CAD was conducted through 3D-CT to determine the skin puncture point,the puncture angle,and the bony anchorage point.During surgery,the procedure was carried out strictly according to the preoperative design under G-arm fluoroscopy,recording surgery duration,the number of fluoroscopy times,contralateral supplementary puncture times,bone cement leakage rate,and the incidence of complications.The preoperative and postoperative Visual Analogue Scale(VAS),Oswestry Disability Index(ODI),and vertebral height restoration were compared.Statistical software SPSS 26.0 was used,with quantitative data expressed as mean±standard deviation,and denoted as(x±s).Results(1)The operation time was(26.21±4.19)min,with a median of 25 min;the number of fluoroscopy was(22.69±6.25)times,with a median of 21 times;the number of contralateral supplementary punctures was 0;(2)the pain level was significantly improved 3 days and 3 months after surgery,the VAS score was decreased,the difference was statistically significant(P＜0.001).There was no statistically significant difference between the VAS score 3 months af-ter surgery and 3 days after surgery(P=0.11,P＞0.05);(3)after 3 days and 3 months,the dysfunction was significantly im-proved,the ODI score was decreased,the difference was statistically significant(P＜0.001).The ODI score at 3 months after surgery was not statistically significant(P＞0.05);(4)the ratio of vertebral height at 3 days and 3 months after surgery was higher than that before surgery,with statistical significance(P＜0.001).The ratio of vertebral height at 3 months after surgery was lower than that at 3 days after surgery,with a difference of 0.60 and the difference was statistically significant(P＜0.001);(5)there were 8 cases of bone cement extravasation and the leakage rate was 19.0％with no posterior vertebra leakage,no symptomatic leakage,and no other complications.Conclusion The unilateral approach PKP method based on preoperative CAD with 3D-CT has a high success rate of puncture,simple operation,and is easy to learn,allowing the formation of a standardized procedure.The introduction of osseous an-choring points can correct the displacement errors caused by skin elasticity.Clinical practice has confirmed that this method is feasible and effective,without the need for expensive assistive equipment.This offers the possibility for popularization in primary hospitals and holds practical clinical reference value.
维普
万方数据
