单侧穿刺椎体成形术治疗Kummell病的疗效观察
摘要
[目的]探讨单侧穿刺椎体成形术治疗Kummell病的临床疗效。[方法] 2014年8月～2018年1月,单侧穿刺椎体成形术治疗Kummell病27例,其中男11例,女16例;年龄57～88岁,平均(71.62±15.14)岁,均不合并下肢神经症状,病椎分别位于T91例,T115例,T129例,L18例,L24例。观察指标包括手术时间、术中骨水泥渗漏、视觉模拟评分(visual analog scale,VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)[结果] 27例均获随访,随访时间12～23个月,平均(16.14±3.22)个月。术中6例发生骨水泥渗漏,其中骨水泥渗入椎间盘内3例、椎体前侧2例、椎管内静脉丛1例;但均未出现神经功能损伤等相关并发症。术前、术后3 d及末次随访时,VAS评分分别为(8.23±1.45)分、(2.24±0.49)分、(1.97±0.62)分,ODI分别为(81.21±9.32)%、(22.13±7.62)%、(21.81±8.23);术后各时间点以上指标均较术前显著改善(P<0.05),术后3 d及末次随访比较差异均无统计学意义(P>0.05)。[结论]对于Kummell病,采用单侧穿刺椎体成形术,可有效缓解腰背痛症状,且并发症少。
引文
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[7]Lee SH,Kim ES,Eoh W.Cement augmented anterior reconstruction with short posterior instrumentation:a less invasive surgical option for Kummell’s disease with cord compression[J].J Clin Neurosci,2011,18(4):509-514.
[8]Kim YJ,Lee JW,Kim KJ,et al.Percutaneous vertebroplasty for intravertebral cleft:analysis of therapeutic effects and outcome predictors[J].Skeletal Radiol,2010,39:757-766.
[9]李军,吴家昌,蒋勇,等.椎体成形术与椎体后凸成形术治疗椎体压缩性骨折疗效的Meta分析[J].中国矫形外科杂志,2014,22(8):697-700.(2018-08-28)
[2]Kim YC,Kim YH,Ha KY.Pathomechanism of intravertebral clefts in osteoporotic compression fractures of the spine[J].Spine J,2014,14(4):659-666.
[3]Benedek TG,Nicholas JJ.Delayed traumatic vertebral body compression fracture,partⅡ:pathologic features[J].Semin Arthritis Rheum,1981,4(2):271-277.
[4]Young WF,Brown D,Kendler A,et al.Delayed post traumatic osteonecrosis of a vertebral body(Kummell’s disease)[J].Acta Orthop Belg,2002,1(1):13-19.
[5]Yu CW,Hsu CY,Shih TT,et al.Vertebral osteonecrosis:MR imaging findings and related changes on adjacent levels[J].Am JNeuroradiol,2007,1(1):42-47.
[6]Baur A,Stabler A,Arbogast S,et al.Acute osteoporotic and neoplastic vertebral compression fractures:fluid sign at MR imaging[J].Radiology,2002,3:730-735.
[7]Lee SH,Kim ES,Eoh W.Cement augmented anterior reconstruction with short posterior instrumentation:a less invasive surgical option for Kummell’s disease with cord compression[J].J Clin Neurosci,2011,18(4):509-514.
[8]Kim YJ,Lee JW,Kim KJ,et al.Percutaneous vertebroplasty for intravertebral cleft:analysis of therapeutic effects and outcome predictors[J].Skeletal Radiol,2010,39:757-766.
[9]李军,吴家昌,蒋勇,等.椎体成形术与椎体后凸成形术治疗椎体压缩性骨折疗效的Meta分析[J].中国矫形外科杂志,2014,22(8):697-700.(2018-08-28)