唐永超,莫国业,张顺聪,梁 德,郭丹青,李永贤,杨志东,江晓兵,李大星,郭惠智.经皮椎体强化术治疗无神经症状Kümmell病的中长期疗效[J].中国脊柱脊髓杂志,2018,(1):38-43. |
经皮椎体强化术治疗无神经症状Kümmell病的中长期疗效 |
中文关键词: Kümmell病 椎体强化术 骨质疏松 |
中文摘要: |
【摘要】 目的:探讨经皮椎体强化术治疗无神经症状Kümmell病的中长期疗效。方法:回顾性分析2009年6月~2013年6月采用经皮椎体强化术治疗且随访时间>2年的32例无神经症状Kümmell病患者的临床资料,其中男4例,女28例,年龄69.95±7.72岁(56~87岁),骨密度T值-3.43±0.22SD(-2.5~-5.1SD)。记录术前、术后3d及末次随访时的VAS评分、Oswestry功能障碍指数(Oswestry disability index,ODI)、伤椎椎体前缘高度、伤椎椎体中线高度、伤椎局部矢状位Cobb角、骨水泥强化椎体形态学改变等。结果:7例患者出现骨水泥渗漏,未出现明显临床症状。随访时间为2.81±0.97年(2~6年)。椎体强化术后3d伤椎椎体高度和局部后凸角度与术前相比均得到显著改善(P<0.05);末次随访时,复位的椎体出现再塌陷,局部后凸角度加重(P<0.05)。术后3d VAS评分和ODI与术前相比均显著下降(P<0.05),末次随访时与术后3d比较均无统计学差异(P>0.05)。随访过程中,所有患者骨水泥椎体均与相邻椎体自发性融合,6例出现骨水泥碎裂和移位,8例骨水泥周围出现透亮线。结论:椎体强化术治疗无神经症状的Kümmell病术后即刻疗效显著,但中长期随访时,骨水泥强化椎体出现塌陷及后凸角度增大,不能提供足够的稳定。 |
Mid-to-long term efficacy analysis of percutaneous vertebral augamentation applied on the Kümmell′s disease without neurological deficit |
英文关键词:Kümmell disease Percutaneous vertebral augmentation Osteoporosis |
英文摘要: |
【Abstract】 Objectives: To evaluate the mid-long term efficacy and safety of percutaneous vertebral augmentation(PVA) applied on the Kümmell′s disease without neurological deficit. Methods: From June 2009 to June 2013, 32 patients(4 males and 28 females, 69.95±7.72 years old on average) with Kümmell′s disease of non-neurological deficit receiving percutaneous vertebral augmentation were reviewed. The average T score of bone mineral density was -3.43±0.22SD. The radiological variations including the Cobb angle, anterior and middle height of index vertebra and the type of bone-cement distribution obtained from X-ray were recorded preoperatively, at 3 days postoperatively and the final follow-up. Meanwhile, the visual analogue scale(VAS) and Oswestry disability index(ODI) scores were also evaluated. Results: The average follow-up time was 2.81±0.97 years(2-6 years). 7 cases were observed with asymptomatic bone-cement leakage. The vertebral height and the Cobb angle significantly improved after operation(P<0.05), however, aggravated at the final follow-up(P<0.05). The ODI and VAS scores decreased significantly after operation(P<0.05), but increased a little without significant difference at the final follow-up compared with those at 3 days postoperatively. In addition, three types of morphological changes of bone-cement vertebrae were detected: (1)spontaneous fusion with adjacent vertebrae occurring in all cases; (2)cement fragmentation or migration found in 6 cases; (3)bright lines found in 8 cases. Conclusions: PVA in treatment of the Kümmell′s disease without neurological deficit abtains a significant short-term efficacy. However, PVA is unable to provide adequate stability in mid-long term follow-up,due to the height loss and kyphosis of the index vertebra aggravating. Close follow-up is mandatory. |
投稿时间:2017-10-19 修订日期:2017-11-20 |
DOI: |
基金项目:广东省科技厅课题资助项目(编号:2016A020215137) |
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