经伤椎椎弓根打压植骨内固定术联合活络骨康丸治疗Ⅲ期Kümmell病临床研究  

Treatment of StageⅢKümmell Disease with Transpedicular Pedicle Compression Bone Grafting and Internal Fixation Combined with Huoluo Gukang Pills

作　　者：王金炉 王庆德[1] 张振辉[1] 姚茂琼 李格 王坤[4] 梅伟 Wang Jinlu;Wang Qingde;Zhang Zhenhui;Yao Maoqiong;Li Ge;Wang Kun;Mei Wei(Spinal Surgery Department,Zhengzhou Orthopedic Hospital,Zhengzhou 450052,China;Graduate Student of Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450002,China;Orthopedics Department of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine Zhengzhou 450000,China;Spinal Orthopedics Department of Zhengzhou People's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市骨科医院脊柱外科,郑州450052 [2]河南省中医院骨科研究生,郑州450002 [3]河南中医药大学第一附属医院骨科,郑州450000 [4]郑州人民医院脊柱骨科,郑州450000

出　　处：《河南外科学杂志》2023年第3期34-37,共4页Henan Journal of Surgery

基　　金：河南省中医药科学研究专项课题(编号:20-21ZY2280)。

摘　　要：目的探讨经伤椎单侧椎弓根打压植骨内固定术联合活络骨康丸治疗Ⅲ期Kümmell病的可行性。方法回顾性分析2016-005-2021-05郑州市骨科医院收治的20例Ⅲ期Kümmell病患者的临床资料。均给予经伤椎椎弓根打压植骨内固定术联合活络骨康丸治疗,评价患者术前、术后第10天、末次随访时的疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、伤椎的椎体前缘高度和Cobb角、Frankle分级,以及术后3个月、6个月时伤椎植骨愈合情况。统计术后并发症发生率。结果全部病例均顺利完成手术,手术时间为(152.15±19.31)min,术中出血量为(356.50±95.66)mL,住院时间为(18.40±2.14)d。所有患者均获(12.80±5.40)个月随访。患者的VAS、ODI、伤椎前缘高度、Cobb角,以及Frankle分级均较术前明显改善,差异均有统计学意义(P<0.05)。患者的生活质量较术前明显提高,伤椎植骨均愈合。末次随访时,3例(15.00%)术前脊髓神经损伤均较重的患者,脊髓神经功能达到C级;另外,3例(15.00%)达到D级,14例(70.00%)达到E级。2例(10.00%)术后出现谵妄的患者,给予口服奥氮平等治疗后痊愈。结论经伤椎椎弓根打压植骨内固定术联合活络骨康丸治疗Ⅲ期Kümmell病,能明显缓解患者的疼痛、恢复伤椎高度、适当矫正后凸畸形、提高患者的生活质量,是一种有效、安全的治疗方式。Objective To explore the feasibility of unilateral pedicle compression and bone grafting internal fixation combined with Huoluo Gukang Pill for the treatment of stage III Kümmell disease through the injured vertebral body.Methods A retrospective analysis was conducted on the clinical data of 20 patients with stage III Kümmell disease admitted to Zhengzhou Orthopedic Hospital from May 2016 to May 2021.All patients were treated with transpedicular compression and bone grafting internal fixation combined with Huoluo Gukang Pill.The pain visual analogue score(VAS),Oswestry dysfunction index(ODI),anterior edge height and Cobb angle of the injured vertebral body,Frankle grade,and bone grafting healing of the injured vertebral body were evaluated before surgery,on the 10th day after surgery,and at the last follow-up.Calculate the incidence of postoperative complications.Results All cases successfully completed the surgery,with a surgical time of(152.15±19.31)minutes,intraoperative blood loss of(356.50±95.66)mL,and hospital stay of(18.40±2.14)days.All patients were followed up for(12.80±5.40)months.The VAS,ODI,anterior edge height of the injured vertebra,Cobb angle,and Frankle grade of the patients were significantly improved compared to before surgery,and the differences were statistically significant(P<0.05).The patient's quality of life has significantly improved compared to before surgery,and the injured vertebrae have all healed with bone grafting.At the last follow-up,3 patients(15.00%)with severe preoperative spinal cord nerve injury achieved spinal cord nerve function at level C,3 patients(15%)at level D,and 14 patients(70.00%)at level E.Two(10.00%)patients with postoperative delirium were treated with oral olanzapine and recovered.Conclusion The treatment of stage III Kümmell disease using pedicle compression and bone grafting internal fixation combined with Huoluo Gukang Pill can significantly alleviate pain,restore the height of the injured vertebra,appropriately correct kyphosis,and improve the quality

关 键 词：伤椎 打压植骨 Kümmell病 

分 类 号：R681.5[医药卫生—骨科学]