高黏度骨水泥椎体成形治疗Kümmell病

Percutaneous vertebroplasty with high-viscosity bone cement treats Kümmell disease

背景:由于经皮椎体成形治疗具有创伤小、疼痛缓解迅速等优点,逐渐被用于治疗Kümmell病,但仍存在较高的骨水泥渗漏率。目的:探讨高黏度骨水泥椎体成形结合过伸体位复位治疗Kümmell病的效果。方法:回顾性分析17例Kümmell病患者的临床资料,其中男5例,女12例,年龄55-83岁,均进行高黏度骨水泥椎体成形过结合过伸体位复位治疗。检测治疗前后的目测类比评分、Oswestry功能障碍指数评分、伤椎椎体高度及伤椎后凸畸形角度,同时记录骨水泥渗漏、肺栓塞、邻近椎体骨折等并发症发生情况。结果与结论:治疗后随访12个月时,患者的目测类比评分、Oswestry功能障碍指数评分、伤椎后凸畸形角度均显著低于治疗前(P<0.05),伤椎椎体高度显著高于治疗前(P<0.05)。治疗后,发生骨水泥渗漏3例,均无特殊不适及神经症状;新发骨折1例。表明采用过伸体位复位结合高黏度骨水泥椎体成形治疗Kümmell病,可有效缓解腰背痛,改善腰背部功能,部分恢复椎体高度,减小后凸畸形角度。

BACKGROUND： Percutaneous vertebroplasty has been gradually used to treat Kümmell disease becauseof less trauma and quick pain relief, but there is still a high rate of bone cement leakage. OBJECTIVE： To investigate the clinical efficacy of percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset for treatment of Kümmell＇s disease. METHODS： The clinical data of 17 patients with Kümmell＇s disease were retrospectively analyzed, including 5 males and 12 females, aged 55-83 years, and all underwent percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset. The visual analog scale, Oswestry disability index score, vertebral body height and vertebral kyphosis angle were determined. The bone cement leakage, pulmonary embolism, adjacent vertebral fractures and other complications were recorded. RESULTS AND CONCLUSION： At the 12 th month of follow-up, the visual analog scale scores, Oswestry disability index scores and vertebral kyphosis angle of patients were significantly lower than those before treatment（P〈0.05）, the vertebral body height was significantly higher than that before treatment（P〈0.05）. After treatment, there were three cases of bone cement leakage, which had no special discomfort and neurological symptoms, and one case of new fractures. These results demonstrate that hyperextension position reset combined with percutaneous vertebroplasty with high-viscosity bone cement in treatment of Kümmell＇s disease can effectively relieve back pain, improve function of the lower back, partially restore vertebral height and reduce kyphosis angle.