弯角装置单侧穿刺经皮椎体成形术治疗Kümmell病的临床疗效  

Clinical analysis of unilateral percutaneous vertebroplasty by using curved injection needle for treatment of Kümmell's disease

作　　者：张大鹏[1] 毛克亚[2] 强晓军[1] ZHANG Da-peng;MAO Ke-ya;QIANG Xiao-jun(First Department of Orthopaedics,Puyang Oilfield General Hospital,Puyang 457001,Henan,China;Department of Orthopaedics,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]濮阳市油田总医院骨一科,河南457001 [2]中国人民解放军总医院骨科,北京100853

出　　处：《脊柱外科杂志》2017年第6期335-338,343,共5页Journal of Spinal Surgery

摘　　要：目的探讨弯角装置单侧穿刺经皮椎体成形术(PVP)治疗Kümmell病的临床疗效。方法收集濮阳市油田总医院骨科2015年1月—2016年1月采用弯角装置单侧穿刺PVP治疗的25例Kümmell病患者的临床资料。记录所有患者术前、术后2 d、末次随访时手术透视次数、骨水泥用量,采用疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评估手术前后腰痛程度及腰椎功能;计算伤椎术前术后相对高度,并观察局部后凸Cobb角恢复情况;观察术中骨水泥渗漏及其他并发症发生情况。结果所有患者均顺利完成手术,随访(6.7±1.5)个月,术中透视(14.7±4.3)次,骨水泥用量(6.2±1.0)mL。术后2 d、末次随访时VAS评分及ODI均较术前明显改善,差异有统计学意义(P<0.05);术后2 d及末次随访时伤椎相对高度及局部后凸Cobb角较术前均明显恢复,差异有统计学意义(P<0.05);5例患者术中出现椎体周围骨水泥渗漏,未出现静脉渗漏、椎管内渗漏、肺栓塞及其他并发症,骨水泥渗漏率为20.0%。结论采用弯角装置单侧穿刺PVP治疗Kümmell病安全、有效,且操作简单,学习曲线平缓。Objective To investigate the clinical efficacy of unilateral percutaneous vertebroplasty(PVP)by using a curved injection needle for the treatment of Kummell,s disease.Methods From January2015to January2016,the clinical data of25patients with Kümmell's disease were collected in this study.The fluoroscopy frequency and cement dosage were recorded at the moment of pre-operation,postoperative2d and final follow-up.The visual analogue sclae(VAS)scores,Oswestry disabitity index(ODI),relative height restoration of the vertebra and Cobb's angles were compared between preoperation and postoperation.The cement leakage(venous leakage and perivertebral leakage)and other complications were observed.Results All the patients were operated successfully.The mean follow-up was(6.7±1.5)months.The mean fluoroscopy frequency was(14.7±4.3)times.The average amount of bone cement was(6.2±1.0)mL.Compared with preoperation,the VAS scores and ODI were improved significantly,and the differences were statistically significant(P<0.05).Compared with preoperative,the relative height and the Cobb’s angles of the injured vertebra were improved significantly at postoperative2d and the final follow-up,and the differences were statistically significant P<0.05).There were5leakages,and the rate of cement leakage was20.0%.There were no intravenous leakage,leakage of spinal canal,pulmonary embolism and other complications.Conclusion It is safe,effective and simple that unilateral PVP by using a curved injection needle for the treatment of Kümmell's disease,with a flat learning curve.

关 键 词：胸椎 腰椎 脊柱骨折 脊柱后凸 骨质疏松 椎体成形术 

分 类 号：R683.2[医药卫生—骨科学]