过伸体位下经皮椎体后凸成形术治疗骨质疏松性Kümmell病的临床疗效  

Clinical analysis of percutaneous kyphoplasty in hyperextension position for treatment of osteoporotic Kümmell's disease

作　　者：黄益奖[1] 汤呈宣[1] 彭茂秀[1] 何少奇[1] 戴鸣海[1] 陈维善[1] 

机构地区：[1]温州医科大学附属第三医院骨科,浙江325200

出　　处：《脊柱外科杂志》2014年第4期235-238,共4页Journal of Spinal Surgery

基　　金：卫生部科研基金(wz20122t11)

摘　　要：目的：探讨于过伸体位下经皮球囊扩张椎体后凸成形术治疗骨质疏松性Kummell 病的初步临床疗效。方法2007年1月～2012年6月手术治疗18例骨质疏松性Kummell病患者，男6例，女12例；年龄62～86岁，平均69．5岁；背部疼痛病史1个月～3年，平均3．5个月。测量术前、术后2 d及末次随访时侧位X线片上受累节段矢状面Cobb角，并采用视觉模拟量表（visual analog scale， VAS）评分及Oswestry功能障碍指数（Oswestry disability index， ODI）评估乎术疗效。结果全部病例随访12～36个月，平均15．8个月。 Cobb角由术前的32．60°±3．82°改善至术后7．60°±1．68°，VAS评分及ODI由术前平均8．7分、88．6％改善至术后平均2．6分、28．6％，差异均有统计学意义（P＜0．01）；末次随访时Cobb角9．60°±2．06°，VAS评分和ODI分别为2．2分和26．4％，与术后2 d时比较差异均无统计学意义（ P＞0．05）。结论过伸体位下球囊扩张椎体后凸成形术是治疗骨质疏松性 Kummell病的有效方法之一。Objective To evaluate the clinical efficacy of the percutaneous kyphoplasty for osteoporotic Kummell’ s dis-ease.Methods A total of 18 patients with osteoporotic Kummell’ s disease underwent percutaneous balloon kyphoptasty from January 2007 to June 2012.There were 6 males and 12 females with the mean age of 69.5 years（range 62 to 86 years）.All patients underwent back pain for 3.5 months （from 1 month to 3 years）.The involved segment sagittal Cobb’s angle was measured pre-and postoperatively （2 d after the operation ） and at the final follow-up.The visual analog scale （ VAS） and Oswestry disability index （ODI） were used to evaluate pain and function .Results Patients were followed up 12-36 months. The pain relieved in all patients.Cobb’s angle improved from preoperative average 32.60°±3.82°to postoperative 7.60°± 1.68°, VAS scores and ODI were improved from an average of 8.7 points, 88.6% before surgery to a postoperative average 2.6 points, 28.6%.The differences was statistically significant （P〈0.01）;Cobb’s angle average was 9.60°±2.06 °and VAS was 2.2 scores and ODI was 26.4%at the final follow-up respectively, compared with 2 d postoperative, the difference was not statistically significant （ P〉0.05 ）.Conclusion With hyperextension body postures , the percutaneous vertebral kyphoplasty is an effective method for the treatment of osteoporosis Kummell’s disease.

关 键 词：脊柱骨折 骨质疏松 椎体后凸成形术 

分 类 号：R683.2[医药卫生—骨科学]