单侧穿刺PVP手术联合过伸体位复位技术治疗无神经症状Kümmell病  

Unilateral puncture PVP surgery combined with hyperextension position technique in the treatment of Kümmell disease

作　　者：李长宽[1] 陈奇[1] 孙翊夫[1] 高旭 邵立伟 LI Chang-kuan;CHEN Qi;SUN Yi-fu(China-Japan Union Hospital of Jilin University,Changchun,Jilin 130000,China.)

机构地区：[1]吉林大学中日联谊医院,吉林长春130000

出　　处：《颈腰痛杂志》2018年第5期555-557,共3页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨单侧穿刺PVP手术治疗无神经症状Kümmell病的近期疗效,并观察术前过伸体位复位的临床价值。方法自2012-10-2015-12共收治26例Kümmell病患者,其中男10例,女16例,年龄57-82岁,平均68.1岁;伤椎分布:T113例,T1210例,L19例,L26例,L33例,其中单椎体骨折21例,双椎体骨折5例。术前均予以过伸体位复位技术,待伤椎高度、后凸畸形有一定程度矫正后,予以单侧穿刺PVP手术。结果 4例术中发生骨水泥渗漏(15.4%)。术后随访16-25个月,平均21.3个月,所有患者术后3 d、末次随访时的VAS评分和ODI指数均较术前显著降低(P<0.05);且其伤椎前缘高度、后凸Cobb角亦较术前有明显矫正效果(P<0.05)。结论Kümmell病通过术前体位过伸复位有利于矫正伤椎高度和后凸畸形,联合单侧PVP手术可较好地降低腰背疼痛、提高日常生活质量,且骨水泥渗漏率较低,疗效可靠。Objective To investigate the curative effect of unilateral puncture PVP surgicaltreatment on Kümmell disease,and to observe the clinical value of preoperative hyperextensionposition reposition. Methods From October 2012 to December 2015, there were 26 patients withKümmell disease, there were 10 males and 16 females with an average age of 68.1 years （ranged 57-82 years）. The distribution of injured vertebrae： T11 in 3 cases, T12 in 10 cases, L1 in 9 cases, L2 in 6cases, L3 in 3 cases, including single vertebral fracture in 21 cases, double vertebral fracture in 5cases. The technique of hyperextension postural reduction was performed before operation, after theinjured vertebra height and kyphosis deformity were corrected to some extent, unilateral puncture PVPoperation was performed. Results Bone cement leakage occurred in 4 cases（15.4%）. All patients werefollowed up for 16-25 months, with an average of 21.3 months. The VAS score and ODI index of allpatients at postoperative 3d and at the last follow-up were significantly lower than before operation（P〈0.05）. The anterior vertebral height and kyphosis Cobb angle were also significantly improved （P〈0.05）. Conclusion Kümmell disease treated by preoperative posture hyperextendibility for correctionof vertebral height and kyphosis, and unilateral PVP surgery can effectively reduce pain and improvethe quality of daily life, and the bone cement leakage rate is low, the curative effect is reliable.

关 键 词：Kümmell病 椎体裂隙征 单侧PVP手术 过伸体位复位 

分 类 号：R589[医药卫生—内分泌]