经皮椎弓根骨水泥螺钉锚定结合椎体成形术治疗Kümmell病的疗效探讨  

Efficacy of percutaneous pedicle screw anchoring combined with vertebroplasty in treatment of Kümmell’s disease

作　　者：高鼎智 石磊[1] 晏铮剑[1] 汪洋[1] 陈富[1] 柯珍勇[1] 邓忠良[1] 楚磊[1] GAO Dingzhi;SHI Lei;YAN Zhengjian;WANG Yang;CHEN Fu;KE Zhenyong;DENG Zhongliang;CHU Lei(Department of Spinal Surgery,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：《重庆医学》2023年第22期3413-3418,3424,共7页Chongqing medicine

基　　金：重庆市渝中区基础研究与前沿探索项目(20210135)。

摘　　要：目的探讨经皮椎弓根骨水泥螺钉锚定结合椎体成形术治疗Kümmell病的临床疗效。方法回顾分析2018年6月至2021年6月该院骨科收治的Kümmell病患者36例,其中男11例,女25例,平均年龄(72.0±10.5)岁。记录术前、术后1 d、术后6个月及术后12个月视觉疼痛模拟评分(VAS)、Oswestry功能障碍指数(ODI)、病椎椎体前后缘高度及矢状位局部Cobb角、骨水泥移位情况、内固定松动情况及其他并发症。结果36例患者均顺利完成手术,术后X线片、CT等影像学检查提示经皮椎弓根骨水泥螺钉锚定住双侧骨水泥团块。所有病例均随访12个月。术后1 d、术后6个月及术后12个月患者VAS及ODI均较术前显著降低,差异有统计学意义(P<0.05)。术后1 d、术后6个月病椎矢状位局部Cobb角较术前明显减小,差异有统计学意义(P<0.05),术后12个月病椎矢状位局部Cobb角与术前比较差异无统计学意义(P>0.05);术后1 d、术后6个月、术后12个月椎体前缘高度较术前增加,差异有统计学意义(P<0.05);术后1 d、术后6个月椎体后缘高度较术前增加,差异有统计学意义(P<0.05),术后12个月椎体后缘高度与术前比较差异无统计学意义(P>0.05)。随访过程中,所有病例未发现骨水泥移位、内固定装置松动、断裂等并发症。结论经皮椎弓根骨水泥螺钉锚定结合椎体成形术治疗Kümmell病安全、有效,能明显缓解疼痛,提高患者生活质量。Objective To investigate the clinical efficacy of percutaneous pedicle screw anchoring combined with vertebroplasty for the treatment of Kümmell’s disease.Methods Thirty-six patients with Kümmell’s disease,including 11 males and 25 females,with an average age of(72.0±10.5)years old,admitted and treated in the orthopedic department of this hospital from June 2018 to June 2021 were retrospectively analyzed.The visual analogue scale(VAS),Oswestry disability index(ODI),anterior and posterior edge height of the diseased vertebrae and sagittal local Cobb angle,cement displacement,internal fixation loosening and other complications were recorded before operation,on postoperative 1 d and in postoperative 6,12 months.Results All 36 patients completed the surgery successfully,and postoperative radiographs and CT imaging showed that the percutaneous pedicle bone cement screws anchored the bilateral cement masses.All cases were followed up for 12 months.The VAS and ODI scores on postoperative 1 d,in postoperative 6,12 months were significantly lower than those before surgery,and the differences was statistically significant(P<0.05).The local Cobb angle in the sagittal position of the diseased vertebra on postoperative 1 d and in postoperative 6 months was significantly reduced compared with that before surger y,and the difference was statistically significant(P<0.05),and the local Cobb angle in the sagittal position of the diseased vertebra in postoperative 12 months was not statistically significant compared with that before surgery(P>0.05);the height of the anterior margin of the vertebral body on postoperative 1 d,in postoperative 6,12 months was increased compared with before surgery,and the difference was statistically significant(P<0.05);the height of the posterior vertebral body margin on postoperative 1 d and in postoperative 6 months was increased compared with that before surgery,and the difference was statistically significant(P<0.05),and there was no statistically significant difference in the height of th

关 键 词：Kümmell病 经皮椎弓根螺钉 椎体成形术 骨质疏松性压缩性骨折 

分 类 号：R687.3[医药卫生—骨科学]