3种骨水泥成形术治疗Kummell病的疗效观察  

Comparison of the curative effect of three methods of cementoplasty in treating Kummell’s disease

作　　者：郭旭[1] 赵卫芹 何建昌 王贵江[1] 刘彬彬 申沧海[1] 孙立山[1] 王丽国[1] 彭宁宁[1] GUO Xu;ZHAO Weiqin;HE Jianchang;WANG Guijiang;LIU Binbin;SHEN Canghai;SUN Lishan;WANG Liguo;PENG Ningning(Division IV,Department of Orthopedics,Cangzhou Municipal Central Hospital,Cangzhou,Hebei Province 061001,China)

机构地区：[1]沧州市中心医院骨四科,河北061001 [2]沧州市中心医院急诊科,河北061001 [3]沧州市人民医院神经外科

出　　处：《介入放射学杂志》2020年第3期309-314,共6页Journal of Interventional Radiology

摘　　要：目的观察对比经皮椎体成形术(PVP),经皮后凸成形术(PKP)和骨填充网袋成形术治疗Kummell病的临床疗效。方法收集2014年1月至2017年12月诊治并接受3种骨水泥成形术治疗的患者74例。根据治疗方式分为3组,其中PVP组38例,PKP组30例,骨填充网袋组6例。记录患者一般资料,对比不同组患者的手术时间,骨水泥注入量,术后骨水泥渗漏情况,术后手术椎体高度恢复和后凸Cobb角改善情况,统计分析术前1 d,术后1 d、术后3个月视觉模拟评分(VAS)及Oswestry功能障碍指数(ODI)变化。结果患者随访时间3~18个月,平均(9.5±1.3)个月,所有患者无严重并发症发生,未见脊髓神经损伤、肺栓塞及针道感染等。手术时间:PVP组(26.3±10.1)min,PKP组(46.1±15.6)min,骨填充网袋组(60.9±18.3)min;骨水泥注入量:PVP组(1.5±0.8)mL,PKP组(2.5±0.9)mL,骨填充网袋组(2.6±0.8)mL;骨水泥渗漏率:PVP组17/38(44.7%),PKP组7/30(23.3%);骨填充网袋组1/6;PKP组及骨填充网袋组的椎体高度恢复、后凸Cobb角较PVP改善组,差异有统计学意义(P<0.05),PKP组与骨填充网袋组差异无统计学意义(P>0.05)。3组患者手术前后VAS评分及ODI评分比较,差异均有统计学意义(P<0.05)。结论3种骨水泥成形术治疗Kummell病骨折是安全可靠的,并能获得良好的止痛效果,改善患者运动功能状态,但PKP和骨填充网袋较PVP在恢复椎体高度、矫正Cobb角等方面更具优势,骨水泥渗漏率更低。Objective To compare the clinical effect of percutaneous vertebroplasty(PVP),percutaneous kyphoplasty(PKP)and bone filling mesh cementoplasty(BFMP)in the treatment of Kummell’s disease.Methods The clinical materials of a total of 74 admitted patients with Kummell’s disease,who were treated with PVP,or PKP,or BFMP during the period from January 2014 and December 2017,were collected.According to the treatment method,the patients were divided into PVP group(n=38),PKP group(n=30)and BFMP group(n=6).The general information of the patients were recorded.The time spent for operation,the injected volume of bone cement,the postoperative bone cement leakage rate,the postoperative vertebral body height recovery,and the improvement of Cobb’s angle were documented,and the results were compared between each other among the three groups.One day before operation,one day and 3 months after operation,the visual analog scale(VAS)score and Oswestry dysfunction index(ODI)score were calculated and the data were statistically analyzed.Results The follow-up period was 3-18 months,with a mean of(9.5±1.3)months.No serious complications such as spinal cord nerve injury,pulmonary embolism and needle tract infection occurred in all patients.In PVP group,PKP group and BFMP group,the time spent for operation was(26.3±10.1)min,(46.1±15.6)min and(60.9±18.3)min respectively,the injected volume of bone cement was(1.5±0.8)mL,(2.5±0.9)mL and(2.6±0.8)mL respectively,the bone cement leakage rate was 44.7%,23.3%and 16.7%respectively.The vertebral body height recovery and the improvement of Cobb’s angle in PKP group and BFMP group were better than those in PVP group,the differences between PKP,BFMP groups and PVP group were statistically significant(P<0.05),while the differences between PKP group and BFMP group were not statistically significant(P>0.05).Statistically significant differences in VAS score and ODI score existed between preoperative values and postoperative ones in all three groups(P<0.05).Conclusion For the treatment of Kumm

关 键 词：Kummell病 经皮椎体成形术 经皮后凸成形术 骨填充网袋 

分 类 号：R687.3[医药卫生—骨科学]