骨水泥强化椎弓根螺钉固定结合椎体后凸成形术治疗Ⅲ型Kummell病  

Bone Cement Augmentation of Pedicle Screw Fixation Combined with Kyphoplasty for Stage Ⅲ Kummell Disease

作　　者：李业成[1] 张巍[2] 张成亮[1] 刘守正[1] 陈刚[1] 朱宝林[1] 

机构地区：[1]江苏省沭阳县人民医院骨科,江苏沭阳223600 [2]江苏省沭阳县人民医院检验科,江苏沭阳223600

出　　处：《实用骨科杂志》2017年第6期496-499,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨骨水泥强化椎弓根螺钉固定结合椎体后凸成形术治疗Ⅲ型Kummell病的临床疗效。方法分析2012年8月至2016年8月我科收治的25例Ⅲ型Kummell病患者的临床资料及随访结果,评估手术时间、术中出血量、术后引流量、住院时间、下床活动时间、术后疼痛缓解程度(VAS评分)、功能改善情况(ODI评分)、后凸Cobb角、手术前后椎体高度纠正、术后并发症等数据。结果平均随访25个月,平均手术时间(150±20)min(150~190min),术中出血量(450±30)mL(400~550mL),术后引流量(180±20)mL(150~200mL),住院时间(11.5±2.5)d,下床活动时间(4.5±1.5)d,统计学显示与术前比较,手术前后椎体高度纠正、后凸Cobb角、VAS评分及ODI评分差异均有统计学意义(P<0.05),术后15个月发生邻近椎体骨折1例,末次随访时,影像学复查无内固定物松动、断裂。结论骨水泥强化椎弓根螺钉固定结合椎体后凸成形术治疗Ⅲ型Kummell病可以矫正脊柱后凸畸形,避免继发性神经损伤及长期卧床并发症,提高生活质量。Objective To evaluate the efficacy of bone cement augmentation of pedicle screw fixation combined with kyphoplasty for stage Ⅲ kummell disease.Methods Between August 2012 and August 2016,25 cases of stage Ⅲ kummell disease were treated by bone cement augmentation of pedicle screw fixation combined with kyphoplasty were included in this study.According to the follow-up results,such as the operation time,blood loss,postoperative drainage,hospitalization,ambulatory re-covery,kyphosis Cobb’s angle,visual analogue scale（VAS）,Oswesay disability index（ODI）,height restoration of the vertebral and complications were assessed.Results Patients were followed up for 22 to 28 months,mean 25 months;the operation time 150 to 190 min,mean（150±20）min;blood loss 400 to 550 mL,mean（450±30）mL;postoperative drainage 150 to 200 mL,mean（180±20）mL;hospitalization 10 to 15 days,mean（11.5±2.5）days;ambulatory re-covery 5 to 7 days,mean （4.5±1.5）days.Compared with pre-operation,significant differences （P〈0.05） were found in kyphosis Cobb’s angle,visual analogue scale（VAS）,oswesay disability index（ODI） and height restoration of the vertebral after post-operation.One case appeared adjacent vertebral fractures at follow up.There were no complications such as fixation loosen and broken.Conclusion Bone cement augmentation of pedicle screw fixation combined with kyphoplasty for stage Ⅲ Kummell Disease,can effectively restore spinal sagittal alignment,avoid vertebral collapse,secondary nerve injury and long-term bed-ridden complications,improve quality of life.

关 键 词：骨水泥强化 椎体后凸成形术 Kummell病 

分 类 号：R683.2[医药卫生—骨科学]