椎体成形结合椎弓钉固定治疗3期Kümmell病△

Vertebroplasty combined with pedicle screw fixation for stage III Kümmell’s disease

摘要:

［目的］ 评价椎体成形术结合椎弓根固定治疗 3 期 Kümmell 病的临床疗效。［方法］ 2016 年—2020 年对 30 例 3 期 Kümmell 病患者，采用椎体成形术结合椎弓根固定手术进行治疗。评价临床与影像资料。［结果］所有患者均顺利完成手术，手术时间 （1.31±0.34） h，术中出血量 （103.33±32.41） ml。随访 24 个月以上，随时间推移，VAS 和 ODI 评分均显著降低 （P< 0.05）。影像方面，与术前相比，术后椎体前缘高度显著增加 （P<0.05），局部后凸 Cobb 角显著减少 （P<0.05）。与术后 2 周相比，术后 24 个月时椎体前缘高度有所减少，而局部后凸 Cobb 角有所增加，但差异均无统计学意义（P>0.05）。至末次随访时， 骨水泥无移位，无内固定松动断裂。［结论］ 椎体成形术结合椎弓根固定治疗 3 期 Kümmell 病可取得满意临床效果。

Abstract:

[Objective] To evaluate the clinical efficacy of vertebroplasty combined with pedicle screw fixation for stage III Kümmell’s disease. [Methods] From 2016 to 2020, a total of 30 patients received vertebroplasty combined with pedicle screw fixation for stage III Kümmell’s disease. The clinical and imaging data were evaluated. [Results] All patients were successfully operated on with operation time of (1.31±0.34) hours, and intraoperative blood loss of (103.33±32.41) ml. After more than 24 months of follow-up, VAS and ODI scores de- creased significantly compared with those preoperatively (P＜0.05) . Radiographically, the anterior vertebral height of the involved vertebrae significantly increased (P＜0.05) , whereas the local kyphotic Cobb angle significantly decreased postoperatively compared with those preop- eratively (P＜0.05) . Compared with those at 2 weeks after surgery, the anterior vertebral height slightly decreased, while the local kyphosis Cobb angle increased at 24 months after surgery, which proved not statistically significant (P＞0.05) . At the latest follow-up, no bone cement displacement, internal fixation loosening or fracture were found in anyone of them. [Conclusion] The vertebroplasty combined with pedicle screw fixation does achieve satisfactory clinical results in the treatment of stage III Kümmell’s disease.