Ⅲ期Kümmell病后柱截骨长节段椎弓钉固定  

Posterior column osteotomy combined with longsegment pedicle screw fixation for stage III Kümmell disease

作　　者：梁晓松 张伟 李大伟 任帅 孙其志 LIANG Xiao-song;ZHANG Wei;LI Da-wei;REN Shuai;SUN Qi-zhi(Department of Spinal Surgery,Tai'an 88 Hospital,Rongtong Medical Groupof China,Tai'an,Shandong 271000,China)

机构地区：[1]中国融通医疗集团泰安八十八医院脊柱外科,山东泰安271000

出　　处：《中国矫形外科杂志》2024年第18期1708-1711,共4页Orthopedic Journal of China

摘　　要：[目的]探讨后柱截骨术(posterior column osteotomy,PCO)和长节段椎弓根钉固定治疗Ⅲ期Kümmell病的疗效。[方法]回顾性分析2019年12月—2022年12月采用PCO截骨和长节段椎弓钉固定治疗Ⅲ期Kümmell病的12例患者的临床资料。评估临床和影像结果。[结果]12例患者均顺利手术,无死亡,无神经损伤加重等严重并发症,手术时间(173.6±37.3)min,术中出血量(335.2±67.8)ml,切口长度(25.6±3.2)cm。其中,2例患者出现谵妄,1例患者术后出现脑脊液漏,经相应处理,均无不良后果。随着术前、术后3个月及术后12个月的时间推移,VAS评分[(8.7±1.2),(2.1±1.1),(1.9±0.8),P<0.001]、ODI评分[(75.7±5.5),(29.7±4.8),(22.4±3.6),P<0.001]和ASIA神经功能评级[C/D/E,(2/10/0),(1/5/6),(1/5/6),P<0.001]均显著改善。影像方面,随时间推移,局部后凸Cobb角[(35.7±5.5)°,(7.1±3.9)°,(7.1±3.5)°,P<0.001]和椎体前缘高度[(18.5±1.3)mm,(23.8±1.2)mm,(23.7±1.3)mm,P<0.001]均有显著改善。[结论]PCO截骨长节段椎弓根钉固定治疗Ⅲ期Kümmell病是一种有效的手术方式。[Objective]To investigate the clinical efficacy of posterior column osteotomy(PCO)and long-level pedicle screw fixationin the treatment of stage III Kümmell's disease.[Methods]A retrospective analysis was performed on 12 patients who received PCO andlong-segment pedicle scrwe fixation for stage III Kümmell's disease in our department from December 2019 to December 2022.The clini-cal and imaging data were evaluated.[Results]All the 12 patients were successfully operated on without death or serious complicationssuch as nerve injury aggravation,whereas with operation time of(173.6±37.3)min,the intraoperative blood loss of(335.2±67.8)ml,and theincision length of(25.6±3.2)cm.Among them,2 patients had delirium and another patient had cerebrospinal fluid leakage after operation,and there were no adverse consequences after corresponding treatment.With the passage of time before surgery,3 months after surgery,and12 months after surgery,the VAS score[(8.7±1.2),(2.1±1.1),(1.9±0.8),P<0.001],ODI score[(75.7±5.5),(29.7±4.8),(22.4±3.6),P<0.001]and ASIA neurological function scale[C/D/E,(2/10/0),(1/5/6),(1/5/6),P<0.001]were significantly improved.In terms of images,the localkyphotic angle[(35.7±5.5)°,(7.1±3.9)°,(7.1±3.5)°,P<0.001]and anterior vertebral height[(18.5±1.3)mm,(23.8±.2)mm,(23.7±1.3)mm,P<0.001]were significantly improved over the time period.[Conclusion]The PCO combined with long-segment pedicle screw fixation isan effective surgical method for the treatment of stage III Kümmell's disease.

关 键 词：骨质疏松症 Kümmell病 后柱截骨 长节段椎弓钉固定 

分 类 号：R681.5[医药卫生—骨科学]