椎体活检钳辅助松解后椎体成形术治疗 Kümmell’s病的疗效观察
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上海中医药大学附属普陀医院骨科

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Percutaneous vertebroplasty with biopsy forcep for the treatment of Kümmell’s disease
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Department of Orthopaedic Surgery, Putuo Hospital, Shanghai University of Traditional Chinese Medicine

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    摘要:

    【目的】探讨活检钳辅助松解后椎体成形术治疗Kümmell’s病的疗效。【方法】:2015年5月到2018年3月间对32例Kümmell’s病患者行火箭钳辅助松解后的椎体成形术治疗,其中男性8例,女性24例;年龄69到85岁,平均75.4岁;腰背痛病时4个月到2年,体位变动是疼痛明显,直立或卧床后减轻。术前完善X线片,CT、MR检查病椎间透亮线、积液或者真空裂隙征。术前术后测量侧位片的Cobb角,并采用VAS评分、日本骨科协会评分(JOA)及Oswestry功能障碍指数(ODI)总和评估手术疗效。【结果】:1例骨水泥渗漏,无症状。侧位X线片示前缘高度及Cobb角分别由术前(32.3±8.2)%和(33.5±10.1)°恢复到术后第二天的(65.6±3.5)%和(10.3±3.0)°,VAS、JOA评分及ODI分别由术前的7.8±1.3、13.3±2.1和(82.3±4.5)%恢复至术后第二天的2.3±1.2、25.3±1.2和(30.3±4.5)%。所有患者均随访至术后6-24个月,平均12.5个月,末次随访是侧位片提示前缘高度及Cobb角为(63.4±4.5)%和(11.3±3.1)°,VAS、JOA评分及ODI分别为2.1±2.2、27.3±1.1和(29.3±3.4)%,这与术后相比均无统计学差异。【结论】:椎体活检钳辅助松解后椎体成形术是治疗Kümmell’s病的有效方法之一。

    Abstract:

    Objective:To explore the efficacy of the percutaneous vertebroplasty with biopsy forcep for the treatment of Kümmell’s disease. Methods: From May 2015 to March 2018, 32 patients with Kümmell’s disease were treated with percutaneous vertebroplasty with biopsy forcep. There were 8 males and 24 females, with a mean age of 75.4 years. All the patients suffered from low back pain for 4 months to 2 years, which increased with postural changes and released after standing up or bed rest. The anterior vertebral height and Cobb angel were measured on standing lateral radiograph pre- and post-operatively(2 days after operation) and during the final follow-up. Visual analog scale(VAS), Japanese Orthopedic Association(JOA) and Oswestry Index(ODI) were used to evaluate pain and function. Results: There was 1 case with cement leakage, but no neurologic symptom. The anterior vertebral height and Cobb angel of the fractured vertebra recovered respectively from 32.3±8.2)% and (33.5±10.1)° preoperatively to(65.6±3.5)%和(10.3±3.0)° postoperatively. VAS、JOA and ODI improved from 7.8±1.3、13.3±2.1 preoperatively and (82.3±4.5)% to 2.3±1.2、25.3±1.2和(30.3±4.5)% postoperatively. All patients were followed up from 6 to 24 months, with an average of 12.5 months. At the latest follow-up, the anterior vertebral height and Cobb angel of the fractured vertebra were (63.4±4.5)%和(11.3±3.1)°, the VAS, JOA and ODI score were 2.1±2.2、27.3±1.1和(29.3±3.4)% respectively, which had no obvious difference with those of post-operative. Conclusion: Percutaneous vertebroplasty with biopsy forcep for the treatment of Kümmell’s disease is safe and effective.

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  • 收稿日期:2020-05-25
  • 最后修改日期:2020-05-25
  • 录用日期:2020-07-17
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