经双侧椎弓根锚定经皮椎体成形术治疗Kümmell病及2年随访  

Bilateral Pedicle Anchoring Technique with Percutaneous Vertebroplasty for the Treatment of Kümmell Disease for 2⁃year Follow⁃up

作　　者：唐寅生 陈亮[1] 贺良杰 杜宇[1] TANG Yin-sheng;CHEN Liang;HE Liang-jie;DU Yu(Department of Spinal Surgery,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院脊柱外科,重庆400010

出　　处：《骨科》2021年第5期403-408,共6页ORTHOPAEDICS

基　　金：重庆市科卫联合医学科研项目(2021MSXM004);重庆医科大学附属第二医院“宽仁英才”项目。

摘　　要：目的探讨经双侧椎弓根锚定经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗Kümmell病的安全性及长期疗效。方法2016年1月至2018年7月,前瞻性地纳入15例Kümmell病病人,其中,女12例,男3例,年龄为(69.0±7.6)岁(55~82岁),均采用经双侧椎弓根锚定PVP手术治疗。收集病人术前、术后1 d、术后2年的疼痛视觉模拟量表(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)、椎体前缘高度及后凸Cobb角,结合术前术后X线片、CT、MRI等影像学资料分析椎体恢复及骨水泥分布情况。结果所有病人均顺利完成手术,术后无严重并发症。术后1 d和术后2年的VAS评分、ODI、椎体前缘高度及伤椎Cobb角均较术前明显改善,差异有统计学意义(P<0.05)。2例病人术中出现骨水泥渗漏,未伴发临床症状,未予特殊处理,术后症状好转,影像学表现正常。结论双侧椎弓根锚定PVP治疗Kümmell病能够稳定伤椎并提升椎体高度,病人生活质量能得到明显改善并可早期进行活动,2年随访结果满意,是治疗Kümmell病安全有效的手术方式。Objective To investigate the safety and long⁃term efficacy of bilateral pedicle anchored percutaneous vertebroplasty(PVP)in the treatment of Kümmell disease.Methods From January 2016 to July 2018,a total of 15 patients with Kümmell disease,including 12 females and 3 males,aged(69.0±7.6)years(55⁃82 years old),were prospectively included.All patients were treated with bilateral pedicle anchored PVP.The visual analogue scale(VAS)scores,Oswestry disability index(ODI),anterior vertebral height and kyphosis Cobb angle were recorded before and 1 day and 2 years after operation.The vertebral recovery and bone cement distribution were analyzed in combination with preoperative and postoperative X⁃ray film,CT,MRI and other imaging data.Results All patients successfully underwent the procedure without serious complications.The VAS scores,ODI,anterior vertebral height and Cobb angles of the injured vertebrae were significantly improved after surgery.Bone cement leakage occurred in two patients,but the patients showed no abnormal clinical symptoms,and no special treatment was given.Postoperative symptoms and imaging showed improvement.Conclusion PVP with the bilateral pedicle anchoring technique can stabilize the injured vertebrae of Kümmell disease and improve the height of the vertebrae,significantly improve the quality of life of the patients and early activities.The 2⁃year follow⁃up results are satisfactory.It is a safe and effective surgical method for the treatment of Kümmell disease.

关 键 词：Kümmell病 骨质疏松性骨折 经皮椎体成形术 

分 类 号：R687.3[医药卫生—骨科学]