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作 者:冯学烽[1] 邹伟民[1] 庞祖才[1] 吴金伟 FENG Xuefeng;ZOU Weimin;PANG Zucai;WU Jinwei(The Fourth Department of Orthopedics,Shunde Hospital of Guangzhou University of Chinese Medicine,Foshan,Guangdong 528333,China)
机构地区:[1]广州中医药大学顺德医院骨伤四科,广东佛山528333
出 处:《中国骨科临床与基础研究杂志》2020年第3期143-148,共6页Chinese Orthopaedic Journal of Clinical and Basic Research
基 金:广东省基础与研究基金联合基金(粤佛)项目计划(2019A1515110630);佛山市科技局课题(1920001000314)。
摘 要:目的评价后路短节段固定结合骨水泥钉道强化技术治疗伴神经症状Kummell病的临床效果。方法将2017年1月至2018年12月广州中医药大学顺德医院收治的12例伴神经症状Kummell病患者纳入研究,患者均采用后路短节段固定结合钉道强化技术。评估患者手术前后日本骨科学会(JOA)评分和疼痛视觉模拟量表(VAS)评分,观察术后后凸Cobb角和椎体高度变化,采用美国脊髓损伤学会(ASIA)分级系统评估神经功能改善情况。结果随访12~15个月,平均随访时间13个月。患者术后3 d及术后1年JOA评分、VAS评分、后凸Cobb角及椎体高度均较术前改善(P<0.05);术前ASIA脊髓损伤分级C型1例、D型4例、E型7例,术后12个月改善为D型3例、E型9例。发生骨水泥渗漏2例,术后观察神经症状未加重。结论后路短节段固定结合钉道强化技术治疗伴神经症状Kummell病,可加强骨折端稳定性,缓解疼痛,改善椎管狭窄引起的神经症状,短期效果满意。Objective To evaluate the clinical effect of posterior short-segment fixation combined with bone cement screw augmentation in the treatment of Kummell's disease with neurological symptoms.Methods Twelve patients with Kummell's disease accompanied with neurological symptoms who treated from January 2017 to December 2018 in Shunde Hospital of Guangzhou University of Chinese Medicine were included in the study.All patients underwent posterior short-segment fixation and bone cement screw augmentation.Japanese Orthopaedic Association(JOA)score and pain visual analogue scale(VAS)score of patients were evaluated before and after the operation,postoperative changes of kyphosis Cobb angle and vertebral height were observed,and the improvement of neurological function was assessed by American Spinal Injury Association(ASIA)grading system.Results Patients were followed up from 12 to 15 months with an average of 13 months.JOA score,VAS score,kyphosis Cobb angle and vertebral height were all improved at 3 days and 1 year after operation(P<0.05).According to ASIA grading system,neurological function was improved from 1 case of C type,4 cases of D type and 7 cases of E type preoperatively,to 3 cases of D type and 9 cases of E type postoperatively.Bone cement leakage occurred in 2 cases,while no aggravate neurological symptoms was found after the operation.Conclusion Treatment of Kummell's disease with neurological symptoms by posterior short-segment fixation combined with bone cement screw augmentation can achieve satisfactory short-term effect,which may increase the stability of fracture site,alleviate the pain,and relieve the symptoms caused by spinal stenosis.
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