骨填充网袋联合椎弓根锚定经皮椎体后凸成形术治疗陈旧性椎体骨折不愈合  

Bone filling mesh bag combined with pedicle anchoring percutaneous kyphoplasty foRKummell disease

作　　者：赵鹏 张云庆[1] 邓雄伟[1] 方剑锋[1] 刘上楼[1] 朱云荣[1] ZHAO Peng;ZHANG Yun-qing;DENG Xiong-wei;FANG Jian-feng;LIU Shang-lou;ZHU Yun-rong(Dept of Orthopaedics,the Affiliated Jiangyin Hospital of Southeast University School of Medicine,Jiangyin,Jiangsu 214400,China)

机构地区：[1]东南大学医学院附属江阴医院骨科,江苏江阴214400

出　　处：《临床骨科杂志》2022年第2期166-170,共5页Journal of Clinical Orthopaedics

基　　金：江苏省卫健委科研项目(编号:Z2019015)。

摘　　要：目的探讨骨填充网袋联合椎弓根锚定经皮椎体后凸成形术治疗陈旧性椎体骨折不愈合(Kummell病)的临床疗效。方法采用骨填充网袋联合椎弓根锚定经皮椎体后凸成形术治疗21例Kummell病患者。记录手术时间、骨水泥注入量、术后首次下床活动时间,比较手术前后疼痛VAS评分、ODI及Cobb角。结果患者均获得随访,时间12~24个月。手术时间30~50(41.7±6.0)min,骨水泥注入量3.5~5.8(4.9±0.5)ml,术后首次下床活动时间4~24(18.4±6.6)h。术中2例发生骨水泥渗漏,均无神经症状;1例发生骨水泥松动移位。疼痛VAS评分、ODI、Cobb角、椎体中线高度术后第2天及末次随访时均较术前明显改善(P<0.05)。末次随访时,患者均可完全负重行走,恢复日常生活。结论骨填充网袋联合椎弓根锚定经皮椎体后凸成形术治疗Kummell病临床疗效良好,能明显改善患者的疼痛症状,降低骨水泥渗漏和移位发生率。Objective To investigate the clinical effect of bone filling mesh bag combined with pedicle anchoring percutaneous kyphoplasty(PKP)in the treatment of old vertebral fracture nonunion(Kummell disease).Methods The 21 patients with Kummell disease were treated with bone filling mesh bag combined with pedicle anchoring PKP.The operation time,the volume of bone cement injection and the time of first postoperative ambulation were recorded,and the pain VAS,ODI and Cobb angle were compared before and afteRthe operation.Results All patients were followed up foR12~24 months.The operation time was 30~50(41.7±6.0)min,the volume of bone cement injection was 3.5~5.8(4.9±0.5)ml,and the time of first ambulation was 4~24(18.4±6.6)h.During the operation,bone cement leakage occurred in 2 cases without neurological symptoms;and bone cement loosening and displacement occurred in 1 case.Compared with the preoperation,pain VAS,ODI,Cobb angle and vertebral midline height were significantly improved at the postoperative 2 d and the last follow-up(P<0.05).At the last follow-up,all patients could walk with full weight-bearing and restore daily life.Conclusions In the treatment of Kummell disease,bone filling mesh bag combined with pedicle anchoring PKP have good clinical efficacy,which can significantly improve the pain symptoms of patients,and reduce the incidence rate of bone cement leakage and displacement.

关 键 词：骨填充网袋 锚定 椎体成形术 陈旧性椎体骨折不愈合 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]