经皮椎体成形术与经皮椎体后凸成形术治疗Kummell病的疗效分析  

Comparison between percutaneous vertebroplasty and kyphoplasty for treatment of Kummell’s disease

作　　者：姚高文[1] 余虹[1] 汪卫[1] 周永强[1] 王勇平[1] 陈晓 YAO Gaowen;YU Hong;WANG Wei;ZHOU Yongqiang;WANG Yongping;CHEN Xiao(Department of Orthopaedics, Neijiang First People’s Hospital, Neijiang 641000, China)

机构地区：[1]内江市第一人民医院骨科,641000

出　　处：《国际骨科学杂志》2020年第6期371-375,共5页International Journal of Orthopaedics

摘　　要：目的探讨经皮椎体成形术(PVP)与经皮椎体后凸成形术(PKP)治疗Kummell病的临床效果。方法回顾性分析2011年6月至2017年9月内江市第一人民医院收治的75例进行PVP或PKP的Kummell病患者的临床资料,其中PVP组35例,PKP组40例。记录两组患者术前及术后3d、末次随访时疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、椎体前缘相对高度、伤椎矢状面Cobb角、骨水泥分布、骨水泥渗漏率、椎体再次塌陷骨折发生率等并进行分析比较。结果两组术后VAS评分、ODI指数均较术前明显改善(P<0.05),术后3d及末次随访时两组间VAS评分、ODI指数差异无统计学意义(P>0.05)。术后3d及末次随访时两组间椎体前缘相对高度、伤椎矢状面Cobb角差异均有统计学意义(P<0.05),PKP组改善效果更佳。PKP组骨水泥分布以团块型为主(65%,26/40),PVP组以混合型为主(45.7%,16/35),两组间差异有统计学意义(P<0.05)。PKP组骨水泥渗漏率为12.5%(5/40),PVP组为22.8%(8/35),两组间差异有统计学意义(P<0.05)。PKP组椎体再次塌陷骨折发生率为7.5%(3/40),PVP组为2.8%(1/35),两组间差异无统计学意义(P>0.05)。结论 PVP与PKP治疗Kummell病均可取得满意效果,PKP在改善后凸畸形、恢复伤椎高度、避免骨水泥渗漏等方面较PVP可能更具优势。Objective To investigate the clinical outcomes of percutaneous vertebroplasty(PVP)versus percutaneous kyphoplasty(PKP)in the treatment of Kummell’s disease.Methods The clinical data of 75 patients with Kummell’s disease undergoing PVP or PKP in the First People’s Hospital of Neijiang City from June 2011 to September 2017 were retrospectively analyzed.There were 35 cases receiving PVP and 40 cases receiving PKP.Visual analogue scale(VAS),Oswestry disability index(ODI),relative height of anterior vertebral body,Cobb angle of injured vertebra in the sagittal plane,distribution of bone cement,leakage rate of bone cement,incidence of vertebral re-collapse fracture were recorded and compared between the both groups.Results The VAS score and ODI index of both groups were significantly improved postoperatively compared with those before operation(all P<0.05).There was no significant difference in terms of VAS scores and ODI index between at 3 days after operation and at the last follow-up in both groups(all P>0.05).There were significant differences in the relative front height of vertebra and Cobb angle of injured vertebrae between at 3 days after operation and at the last follow-up in both groups(all P<0.05),and the PKP group exhibited significant improvement in comparison with the PVP group.The distribution of bone cement in the PKP group was mainly clump type(65%,26/40),and in the PVP group was mainly mixed type(45.7%,16/35),with statistically significant difference(P<0.05).The leakage rate of bone cement was 12.5%(5/40)in the PKP group and 22.8%(8/35)in the PVP group,with significant difference(P<0.05).There was no significant difference in terms of the rate of vertebral re-collapse fracture between both groups(P>0.05).Conclusion Both PVP and PKP could achieve satisfactory results in the treatment of Kummell’s disease.PKP may be superior to PVP in the correction of kyphosis,restoration of vertebral height and prevention of bone cement leakage.

关 键 词：Kummell病 经皮椎体成形术 经皮椎体后凸成形术 

分 类 号：R68[医药卫生—骨科学]