椎体后凸成形术治疗骨质疏松性Kümmell’s病的效果观察

Percutaneous Kyphoplasty for the Treatment of Osteoporotic Kümmell's Disease

目的:观察经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性Kümmell’s病的临床效果。方法:2011年8月-2017年11月,对20例应用经皮椎体后凸成形术治疗骨质疏松性Kümmell’s病患者的临床资料进行回顾性分析。结果:本组20例骨质疏松性Kümmell’s病患者均应用经皮椎体后凸成形术,术后均获随访3个月~6年,平均36个月。其中手术时间20~90 min,平均(50.5±19.39)min;术中出血5~20 ml,平均(11.75±3.52)ml;住院时间4~13 d,平均(7.45±1.88)d。患者术后当天,及末次随访时VAS平均评分分别为(2.10±0.97)分、(1.10±0.72)分,与术前(8.75±1.21)分比较差异均有显著统计学差异(P<0.05)。平均患椎前缘高度自术前的(15.00±1.52)mm恢复到术后的(20.35±1.14)mm,差异有统计学意义(P<0.05),末次随访时为(21.05±0.94)mm,与术后当天比较差异无统计学意义(P>0.05)。结论:经皮椎体后凸成形术治疗骨质疏松性Kümmell’s病,组织损伤小、出血少、安全性较高,是治疗肱骨外科颈骨折较为理想的方法。

Objective：To observe the curative effect of the treatment of osteoporotic Kümmell’s disease by applying percutaneous kyphoplasty（PKP）.Method：From August 2011 to November 2015,a retrospective analysis was performed on the clinical data of 20 cases with osteoporotic Kümmell’s disease treated by PKP.Result： 20 cases were followed up for 3-6 years after operation.The average length of operation time was（50.5±19.39）min（from 20 min to 90 min）,the average volume of bleeding in operation was （11.75±3.52） ml（from 5 ml to 20 ml）;the length of hospital stay was （7.45±1.88）days（from 4 d to 13 d）.VAS scores were （2.10±0.97）points and （1.10±0.72）points at the same day and last follow-up postoperatively,which were significantly lower than the preoperative one （8.75±1.21）points（P〈0.05）.The anterior vertebral height of the fractured vertebra improved from （15.00±1.52）mm preoperatively to （20.35±1.14）mm postoperatively,and （21.05±0.94）mm at the last follow-up,there was significant improvement between pre-operative and post-operative measurement（P〈0.05）.But no difference between post-operative and the last follow-up was observed（P〉0.05）.Conclusion： Using PKP for the treatment of osteoporotic Kümmell’s disease provides less tissue injury,less bleeding,and high security,which is an ideal method of the treatment of Kümmell’s disease.