椎体后凸成形术治疗无神经症状Kümmell病的疗效观察  

Kyphoplasty for Kümmell disease without neurological deficit

作　　者：柳扬[1] 包呼日查 孙永青[1] 范磊[1] 郝敬东[1] 崔准[1] 张怀华[1] 康建国[1] 任磊[1] 邓超[1] 赵大中[1] 蒋育欣 

机构地区：[1]首都医科大学教学医院,国家电网北京电力医院骨科,北京100073 [2]内蒙古自治区人民医院骨科,呼和浩特010017

出　　处：《中国骨与关节外科》2013年第6期477-481,共5页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:目前,Kümmell病相关文献报道较少,诊断和治疗仍存争议,对于此病的认识有待进一步加深。目的目的:深化对Kümmell病的认识并探讨椎体后凸成形术治疗无神经症状Kümmell病的短期疗效。方法方法:2007年2月至2012年3月,13例无神经症状Kümmell病患者接受球囊扩张椎体后凸成形术。分别于术前、术后记录Oswestry功能障碍指数(ODI)、疼痛视觉模拟评分(VAS)、伤椎和邻椎高度、受累节段矢状面Cobb角,认为VAS减少50%为疼痛明显缓解,ODI减少50%为功能明显改善。结果结果:患者术后3 d,1个月、3个月、12个月VAS平均评分分别为6.7±0.88、4.3±0.64、3.6±0.69和3.2±0.90,与术前比较均有显著统计学差异(P<0.05),末次随访时疼痛缓解率为81%。12例患者的运动功能有明显改善;术后3 d,1个月、3个月、12个月ODI平均评分分别为23.5±1.90、15.0±0.86、13.8±0.60和12.5±0.50,与术前比较均有显著统计学差异(P<0.05),末次随访时运动功能改善率为71%。术后伤椎高度较术前明显增加,术后12个月时伤椎高度平均为(18.5±1.59)cm,与术前比较有显著统计学差异(P<0.05)。但术后随访时各时间点邻椎高度较术前无明显改变(P>0.05)。术后伤椎节段Cobb角较术前明显减小,术后12个月时伤椎节段Cobb角平均为14.6°±1.46°,与术前比较有显著统计学差异(P<0.05)。结论结论:目前对于Kümmell病的认识仍存不全面;椎体后凸成形术是治疗无神经症状Kümmell病有效方法之一。Background：There are few studies reported on Kummell＆#39;s disease. Therefore, it remains incomplete. 〈br〉 Objective：To evaluate the efficacy of kyphoplasty for K＆#252;mmell disease in patients without neurological deficit. 〈br〉 Methods：Thirteen patients with K＆#252;mmell disease without neurological deficit were treated with kyphoplasty from February 2007 to March 2012. The visual analogue scale （VAS）, Oswestry disability index （ODI）, and the height and kyphotic angle of involved vertebral body were measured to evaluate clinical outcomes before and after surgery. The successful treatment was defined as VAS or ODI reduction at least 50%. 〈br〉 Results：VAS scores were 6.7＆#177;0.88, 4.3＆#177;0.64, 3.6＆#177;0.69 and 3.2＆#177;0.90 at 3 d, 1 month, 3 months and 12 months postopera-tively, which were significantly lower than the preoperative one （7.9 ＆#177; 0.70, P＆lt;0.05）. The rate of pain relief was 81%. ODI were 23.5＆#177;1.90, 15.0＆#177;0.86, 13.8＆#177;0.60 and 12.5＆#177;0.50 at 3 d, 1 month, 3 months and 12 months postoperatively, which were significantly lower than the preoperative one （30.8＆#177;4.60, P＆lt;0.05）. The function improving rate was 71%at the final follow-up. The motor function was improved significantly after surgery in 12 patients. The mean injured vertebral height increased from （13.8 ＆#177; 1.36） cm preoperatively to （18.5 ＆#177; 1.59） cm 12 months postoperatively （P＆lt;0.05）. The mean Cobb angle of in-volved vertebrae reduced significantly from 20.8＆#176;＆#177;2.46＆#176; preoperatively to 14.6＆#176;＆#177;1.46＆#176; 12 months postoperatively （P＆lt;0.05）. There was no significant difference in adjacent vertebral height before and after surgery. 〈br〉 Conclusions：The current understanding of Kummell＆#39;s disease is still limited. Kyphoplasty is effective for K＆#252;mmell disease in the patients without neurological deficit.

关 键 词：Kummell病 椎体后凸成术 

分 类 号：R687.3[医药卫生—骨科学]