椎体后凸成形术治疗无神经症状的中晚期Kümmell病的疗效分析  

Evaluation of the clinical outcome of kyphoplasty for treatment of the middle and late period Kümmell disease without neurological deficit

作　　者：张云庆[1] 杨惠光[1] 刘勇[1] 邓雄伟[1] 周枫[1] 骆文兴[1] 方剑锋[1] 

机构地区：[1]东南大学医学院附属江阴医院骨科,214400

出　　处：《中华损伤与修复杂志（电子版）》2013年第1期38-41,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的探讨椎体后凸成形术治疗无神经症状的中晚期Kümmell病的可行性及疗效分析。方法自2003年5月至2009年2月,应用椎体后凸成形术治疗27例(男10例,女17例)无神经症状的中晚期Kümmell病患者(Ⅱ期9例,Ⅲ期28例)。术后疼痛改善采用疼痛视觉模拟评分(VAS)评估,生活能力改善采用Oswestry功能障碍指数(ODI)评估;观察并计算椎体高度的恢复和后凸畸形的矫正情况。结果所有患者均顺利完成手术,其中3例失随访,1例随访不足1年,均未纳入统计。23例患者获得1年以上的随访(18～42个月),平均28个月,术前、术后1周及末次随访时VAS平均评分分别为8.1±1.4、3.2±0.9和2.8±1.6,与术前比较差异有统计学意义(P<0.05)。术前、术后1周及末次随访时ODI分别为(73.9±6.8)%、(41.7±8.1)%和(29.8±8.2)%,与术前比较差异有统计学意义(P<0.05)。术前、术后1周及末次随访时椎体前缘高度分别为11.9±3.1、19.1±2.9和18.9±4.1,与术前比较差异有统计学意义(P<0.05)。术前、术后1周及末次随访时椎体中间高度分别为14.6±2.2、21.3±2.6和19.9±3.5,与术前比较差异有统计学意义(P<0.05)。术前、术后1周及末次随访时椎体后缘高度分别为24.1±4.2、24.3±4.6和23.9±3.7,与术前比较差异无统计学意义(P>0.05)。术前、术后1周及末次随访时椎体后凸角分别为22.8±5.2、13.2±6.5和13.8±4.9,与术前比较差异有统计学意义(P<0.05)。3例患者发生骨水泥渗漏(2例椎间隙,1例椎旁软组织内),均无临床症状。结论椎体后凸成形术治疗无神经症状的中晚期Kümmell病可有效缓解腰背痛,改善功能,部分恢复椎体高度,减小后凸畸形,恢复脊柱矢状序列,是治疗此类疾患的有效方法之一。Objective To evaluate the practicability and efficacy of kyphoplasty for treatment of the middle and late period Kummell disease without neurological deficit. Methods From May 2003 to February 2009, 27 patients （10 male, 17 female） of the middle and late period Kummell disease were treated with kyphoplasty. The therapeutic efficacy as determined by the visual analogue scale （VAS） and the oswestry disability index （ODI）. The height and the kyphotic angle of the involved vertebral body were measured and reckoned preoperatively and postoperatively. Results All patients were successfully completed the surgical procedure. Four patients were excluded in this study （3 patients lost follow-up and 1 patient was followed up less than 1 year）. Twenty-three patients were followed-up from 18 months to 42 months （mean 28 months）. The mean VAS score decreased significantly from 8.1 ± 1.4 to 3.2 ±0.9 one week postoperatively and 2.8 ± 1.6 at the last follow-up （ P 〈 0.05 ）. The mean ODI improved significantly from 73.9 ± 6.8 preoperatively to 41.7 ± 8.1 one week postoperatively and 29.8 ± 8.2 at the last follow-up （P 〈 0.05 ）. The mean anterior vertebral height increased significantly from 11.9 ± 3.1 preoperatively to 19.1 ±2.9 one week postoperatively and 18.9±4. 1 at the last follow-up （P 〈0.05 ）. The mean medial vertebral height increased significantly from 14. 6 ± 2. 2 preoperatively to 21. 3 ± 2. 6 one week postoperatively and 19.9 ± 3.5 at the last follow-up （ P 〈 0.05 ）. The mean posterior vertebral height was 24.1 ± 4.2 preoperatively and 24.3 ± 4.6 one week postoperatively and 23.9 ± 3.7 at the last follow-up （ P 〉 0.05 ）. The mean vertebral kyphotie angle improved significantly from 22.8 ± 5.2 preoperatively to 13.2 ±6.5 one week postoperatively and 13.8 ± 4.9 at the last follow-up （P 〈 0.05 ）. Asymptomatic cement leakage of intravertebral space was observed in 2 patient and asymptomatic cement leakage of soft tissue next to vertebrae was observe

关 键 词：Kümmell病 椎体后凸成形术 治疗方法 

分 类 号：R687.3[医药卫生—骨科学]