固定角度导板应用于单侧椎体后外上方入路椎体后凸成形术的临床研究OA

Objective To evaluate the efficacy of a self-designed fixed-angle guide in assisting puncture during unilateral posterolateral superior approach kyphoplasty(PKP).Methods A retrospective analysis was conducted on 58 patients with single-level osteoporotic vertebral compression fractures who underwent PKP via this approach between June 2021 and June 2023.Among them,27 patients received guide-assisted puncture(Guide group)and 31 received freehand puncture(Freehand group).Operative time,number of intraoperative fluoroscopies,rate of satisfactory bone cement distribution,Visual Analog Scale(VAS)score,and Oswestry Disability Index(ODI)were compared between the two groups preoperatively and at 1 day,3 months,and 6 months postoperatively.Results The mean follow-up duration was(7.23±1.35)months.The Guide group showed shorter operative time[(33.03±4.06)min vs(37.52±10.74)min]and fewer fluoroscopies[(24.07±2.97)times vs(35.20±2.09)times](both P<0.05).The rate of satisfactory cement distribution was higher in the Guide group(92.6%vs 71.0%,P<0.05).On postoperative day 1,the VAS score was lower in the Guide group[(1.41±0.50)vs(4.30±0.74),P<0.05],with no significant differences at 3 and 6 months.No significant differences in ODI were observed between the two groups at any time point(P>0.05).Conclusion The use of a fixed-angle guide in unilateral posterolateral superior approach PKP facilitates accurate puncture,reduces operative time and radiation exposure,and provides better early postoperative pain relief,supporting the standardized application of this technique.