经椎弓根椎体内骨水泥强化结合后路短节段内固定治疗Kummell病43例

A therapeutic efficacy of the transpedicular intracorporeal cement augmentation with short segmental posterior instrumentation in treating kummell disease

目的:分析经椎弓根椎体内骨水泥强化,结合后路短节段内固定治疗Kummell病的疗效。方法:采用后路短节段固定以及椎体强化手术治疗Kummell病患者43例,进行5年随访,分析临床疗效,包括疼痛视觉评分(VAS)、Oswestry功能指数(ODI)、椎体平均高度及后凸cobb氏角。结果:VAS评分以及ODI在术后6月左右时明显改善,但5年后随访结果显示VAS以及ODI与术前参数比较,差异无统计学意义。影像结果分析显示,平均Cobb氏角以及椎体平均高度在术后6月左右显著改善,但这种矫正在术后逐渐丢失。结论:经椎弓根椎体内骨水泥强化联合后路短节段固定,在短期内可以改善Kummell病患者症状,但远期治疗结果并不理想。

Objective：The purpose of this study was to investigate the therapeutic efficacy of transpedicular intracorporeal cement augmentation in treating Kummell disease for 5-years follow-up period.Methods：43patients were followed for at least 5years after transpedicular cement augmentation with short-segmental posterior instrumentation.We retrospectively reviewed outcomes,including visual analogue scale score,the Oswestry Disability Index score,compression ratio,and kyphotic angle.Results：The mean visual analogue scale score was exhibiting Vshaped upward trend after postoperative 6months that ended with the almost similar score obtained with preoperative status.The mean Oswestry Disability Index score was also shown with similar trend.In functional score,there was a statistical significant improvement until only 6months after surgery.In radiological evaluation,the mean kyphotic angle and average body height was significantly corrected after surgery.However,these improved radiological parameters were maximal at the immediate postoperative time with gradual loss over time.Conclusion：Transpedicular cement augmentation with short-segmental posterior instrumentation may lead to prolonged back pain and recurrence of kyphotic deformity in the 5years after the procedure.Therefore,we do not recommend short-segmental posterior instrumentation concurrently with transpedicular cement augmentation for treating Kummell disease.