骨填充网袋成形术与经皮椎体后凸成形术治疗Kümmell病的疗效比较  

Comparison of vesselplasty and percutanous kyphoplasty in the treatment of Kümmell disease

作　　者：姚树强[1] 吴瑞[1] 周纪平[1] 杨永军[1] 谭远超[1] 杨凯[1] 李佳佳[1] 姜泽威 刘彬[1] YAO Shu-qiang;WU Rui;ZHOU Ji-ping;YANG Yong-jun;TAN Yuan-chao;YANG Kai;LI Jia-jia;JIANG Ze-wei;LIU Bin(No.1 Ward of Spine,Shandong Wendeng Osteopathic Hospital,Wendeng 264400,Shandong,China)

机构地区：[1]威海市文登整骨医院脊柱脊髓科一,山东文登264400

出　　处：《中国骨伤》2022年第5期429-434,共6页China Journal of Orthopaedics and Traumatology

基　　金：山东省中医药科技发展项目(编号:2019-0794)。

摘　　要：目的:比较骨填充网袋成形术与经皮椎体后凸成形术(percutanous kyphoplasty,PKP)治疗Kümmell病的临床疗效。方法:对2018年7月至2019年12月收治的Kümmell病患者进行回顾性分析,根据不同的治疗方法分为网袋组及PKP组。网袋组20例,男2例,女18例;年龄54~83(67.40±7.44)岁;T_(10)骨折1例,T_(12)骨折3例,L_(1)骨折9例,L_(2)骨折5例,L_(3)骨折2例。PKP组20例,男3例,女17例;年龄56~81(67.20±7.01)岁;T_(10)骨折2例,T_(11)骨折1例,T_(12)骨折6例,L_(1)骨折10例,L_(3)骨折1例。记录两组患者术前,术后1 d和术后1年的视觉模拟评分(visual analogue scale,VAS),Cobb角及椎体前缘高度变化,观察术前、术后1个月和术后1年的Oswestry功能障碍指数(Oswestry Disability Index,ODI),比较两组术后骨水泥渗漏率。结果:所有患者获得1年以上的随访。网袋组术后1年VAS(1.20±0.41)分,Oswestry功能障碍指数(13.50±3.10)%,Cobb角(17.20±3.12)°,椎体前缘高度(20.20±1.35)mm;PKP组术后1年VAS(1.15±0.40)分,Oswestry功能障碍指数(13.20±3.00)%,Cobb角(17.10±3.19)°,椎体前缘高度(20.10±1.37)mm;组内对比两组均较术前显著好转(P<0.05),组间对比差异无统计学意义(P>0.05)。网袋组共20例20椎,其中1例出现骨水泥向上终板处渗漏,渗漏率为5%;PKP组20例20椎,骨水泥向上终板渗漏3例,向下终板渗漏1例,向椎体前方渗漏1例,向椎体侧方渗漏2例,共7例,渗漏率为35%。两组对比差异有统计学意义(P<0.05)。结论:网袋成形术在Kümmell病的治疗中可更好地降低骨水泥渗漏率,减少并发症产生。Objective:To compare the efficacy between vesselplasty and percutanous kyphoplasty(PKP)in the treatment of Kümmell disease.Methods:The clinical data of patients with Kümmell disease from July 2018 to December 2019 were retrospectively analyzed.According to the different therapeutic methods,the patients were divided into vesselplasty group and PKP group.There were 20 patients in vesselplasty group,including 2 males and 18 females,aged from 54 to 83 years with an average of(67.40±7.44)years,1 case of T_(10) fracture,3 cases of T_(12) fracture,9 cases of L_(1) fractures,5 cases of L_(2) fractures and 2 cases of L_(3) fractures.There were 20 patients in PKP group,including 3 males and 17 females,aged from 56 to 81 with an average of(67.20±7.01)years,2 cases of T_(10) fracture,1 case of T_(11) fracture,6 cases of T_(12) fracture,10 cases of L_(1) fracture and 1 case of L_(3) fracture.Visual analogue scale(VAS),Cobb angle,anterior vertebral height were recorded before operation,1 day after operation and 1 year after operation.Oswestry Disability Index(ODI)was recorded before operation,1 month after operation and 1 year after operation.And bone cement leakage rate was compared between two groups after operation.Results:All the patient were followed up for more than 1 year.In vesselplasty group,VAS score was 1.20±0.41,ODI was(13.50±3.10)%,Cobb angle was(17.20±3.12)°and anterior vertebral height was(20.20±1.35)mm at 1 year after operation.In PKP group,VAS score was 1.15±0.40,ODI was(13.20±3.00)%,Cobb angle was(17.10±3.19)°and anterior vertebral height was(20.10±1.37)mm at 1 year after operation.These index was significantly better than pre-operation through intra-group comparison(P<0.05),and there was no statistically difference between the two groups(P>0.05).There were 20 cases(20 vertebrae)in vesselplasty group,of which 1 case had bone cement leakage at the upper endplate,with a leakage rate of 5%(1/20).In PKP group,there were 20 cases(20 vertebrae),3 cases of upward endplate leakage(3/7),1 case of downwar

关 键 词：Kümmell病 经皮椎体后凸成形术 骨水泥渗漏 骨质疏松 

分 类 号：R683.2[医药卫生—骨科学]