聚甲基丙烯酸甲酯骨水泥椎体后凸成形治疗老年Kummell病  

Kyphoplasty with polymethylmethacrylate bone cement treats Kummell disease in the elderly

作　　者：李志君[1] 郑玉鹏[1] 江天蔚[1] 时永臣[1] Li Zhi-jun;Zheng Yu-peng;Jiang Tian-wei;Shi Yong-chen(Third Department of Orthopedics, Second People’s Hospital of Dalian City, Dalian 116011, Liaoning Province, China)

机构地区：[1]大连市第二人民医院骨三科,辽宁省大连市116011

出　　处：《中国组织工程研究》2017年第30期4757-4762,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:经皮椎体后凸成形治疗骨质疏松性椎体压缩骨折可快速疼痛缓解,恢复椎体高度及矫正后凸畸形,而关于其治疗Kummell病的报道不多。目的:评估聚甲基丙烯酸甲酯注射椎体后凸成形治疗Kummell病的疗效及安全性。方法:纳入31例老年Kummell病患者,其中男6例,女25例,年龄58-72岁,涉及T_(11)椎体5个,T_(12)椎体11个,L_1椎体8个,L_2椎体4个,L_3椎体2个,L_4椎体1个,均进行聚甲基丙烯酸甲酯注射椎体后凸成形治疗,治疗前后进行疼痛、生活能力及影像学评估。结果与结论:①疼痛缓解:31例患者治疗后3 d、3个月、12个月的目测类比评分均明显低于治疗前(P<0.05);②生活能力:31例患者治疗后3 d、3个月、12个月的平均Oswestry功能障碍指数评分均明显低于治疗前(P<0.05);③影像学评估:31例患者治疗后3 d、3个月、12个月的伤椎椎体前缘高度及椎体中线高度均明显高于治疗前(P<0.05),Cobb角明显低于治疗前(P<0.05);④不良反应:未发生椎管内及血管内骨水泥渗漏,未发生与骨水泥材料相关的不良反应;⑤结果表明:聚甲基丙烯酸甲酯椎体后凸成形治疗老年Kummell病可快速缓解疼痛,重建脊柱稳定性,改善患者生活质量且安全性较高。BACKGROUND:Percutaneous kyphoplasty is an effective method for the treatment of osteoporotic vertebral compression fracture,because it can relieve pain quickly,restore the vertebral height and correct kyphosis.However,little is reported on percutaneous kyphoplasty for the treatment of Kummell disease.OBJECTIVE:To evaluate the efficacy and safety of kyphoplasty with polymethylmethacrylate bone cement in treating Kummell disease in the elderly.METHODS:Thirty-one patients(6males and25females)with Kummell disease,aged58-72years old,were included in this study.Affected segments involved T11in5cases,T12in11cases,L1in8cases,L2in4cases,L3in2cases,L4in1case.All the patients underwent percutaneous kyphoplasty with polymethylmethacrylate bone cement.The clinical effect was evaluated by pain,viability and imaging changes before and after therapy.RESULTS AND CONCLUSION:(1)Pain relief:The visual analogue scale score for all the31patients at3days,3months and12months after the surgery were significantly lowered compared to the preoperative scores(P<0.05).(2)Viability:The mean Oswestry disability index scores for31patients at3days,3months and12months after the surgery were significantly lowered compared to the preoperative scores(P<0.05).(3)Imaging evaluation:The anterior vertebral height and vertebral height at middle line for31patients at3days,3months and12months after the surgery were higher compared to the preoperative data(P<0.05),and Cobb angles were significantly lowered compared to the preoperative data(P<0.05).(4)Adverse reaction:There was no leakage of bone cement in the vertebral canal and vein,and no adverse reaction occurred related to bone cement.In summary,the kyphoplasty with polymethylmethacrylate bone cement is safe and effective in treating Kummell disease in the elderly.It can fast relieve pain,improve patients quality of life,and reconstruct the spinal stability.

关 键 词：生物材料 骨生物材料 骨水泥 Kummell病 骨质疏松 椎体后凸成形术 椎体内真空裂隙 临床疗效 目测类比评分 Oswesty功能障碍指数 

分 类 号：R318[医药卫生—生物医学工程]