骨水泥减压灌注椎体后凸成形术治疗老年Kümmell病的疗效  

The efficacy of percutaneous kyphoplasty using bone cement decompression perfusion technique in the treatment of Kümmell's disease

作　　者：李志君[1] 江天蔚[1] 姚琦[1] 苏诗瑶 王齐敏[2] LI Zhijun;JIANG Tianwei;YAO Qi;SU Shiyao;WANG Qimin(The Second People's Hospital of Dalian,Dalian 116000,Liaoning,China;The Second Affiliated Hospital of Dalian Medical University,Dalian 116023,Liaoning,China)

机构地区：[1]大连市第二人民医院,辽宁大连116000 [2]大连医科大学附属第二医院,辽宁大连116023

出　　处：《西部医学》2023年第6期904-909,共6页Medical Journal of West China

基　　金：大连医学科学研究计划项目(1711037)。

摘　　要：目的探讨经皮椎体后凸成形术(PKP)中使用骨水泥减压灌注技术治疗Kümmell病的疗效及安全性。方法纳入2017年11月—2019年12月大连市第二人民医院脊柱外科住院并接受PKP治疗的Kümmell患者60例,随机分为A、B、C组,每组20例,A组使用传统骨水泥灌注技术,B组使用骨水泥间隔灌注技术,C组使用骨水泥减压灌注技术。在术前、术后及随访时对患者疼痛、功能障碍指数、骨水泥渗漏情况及影像学结果进行分析。结果所有患者手术顺利完成,无严重并发症发生,术后所有患者胸腰背疼痛均有改善。3组VAS评分、ODI评分在术前、术后比较差异均有统计学意义(P<0.05);3组手术前、术后VAS评分、ODI评分组间比较差异均无统计学意义(P>0.05)。C组病椎手术后测量椎体前缘高度、椎体中部高度、Cobb角与术前比较差异有统计学意义(P<0.05);3组病椎手术后测量椎体前缘高度、椎体中部高度、Cobb角、ODI评分组间比较差异无统计学意义(P>0.05)。3组使用不同的注射方法,在骨水泥渗漏至周缘的方面B、C组较A组明显降低(P<0.05)。而3种注射方法在骨水泥渗漏至椎间盘方面差异均无统计学意义(P>0.05)。3组骨水泥注射量基本相同,但注射时间B组较其他两组明显延长(P<0.05)。结论经皮穿刺椎体后凸成形术中使用骨水泥减压灌注技术治疗Kümmell病方法简单,安全性高,渗漏率低且不延长手术时间,可缓解患者疼痛,有效改善患者生活质量。Objective To evaluate the efficacy and safety of percutaneous kyphoplasty using bone cement decompression perfusion technique in the treatment of Kummell disease.Methods 60 cases of Kümmell's disease were treated by percutaneous kyphoplasty under“C”armed fluroscopy image guiding.Traditional technique,interval perfusion technique and decompression perfusion technique were used in the operation.The clinical effect was evaluated by observing the charges of visual analog scale(VAS),Oswestry disability index(ODI),the Cobb′s angle and height of vertebral bodies.Results The operation was successfully completed in all patients without serious complications,and the chest,waist and back pain of all patients were improved after operation.The VAS score and ODI score of the three groups were significantly different before and after operation(P<0.05).There was no significant difference in VAS score and ODI score between the three groups before and after operation(P>0.05).In group C,there were statistically significant differences in the measurement of the height of the front edge of the vertebral body,the height of the middle of the vertebral body,and the Cobb angle between before and after surgery(P<0.05).There was no significant difference between the three groups in measuring the height of the front edge of the vertebral body,the height of the middle of the vertebral body,Cobb angle and ODI score after the operation of the diseased vertebra(P>0.05).With different injection methods,the leakage of bone cement to the periphery in group B and C was significantly lower than that in group A(P<0.05).However,there was no significant difference in the leakage of bone cement to intervertebral discs among the three injection methods(P>0.05).The injection amount of bone cement was basically the same in the three groups,but the injection time of group B was significantly longer than that of the other two groups(P<0.05).Conclusion The percutaneous kyphoplasty using bone cement decompression perfusion technique is simple and safe i

关 键 词：椎体后凸成形术 骨质疏松 减压灌注技术 Kümmell病 椎体内真空裂隙 

分 类 号：R681[医药卫生—骨科学]