改良与传统穿刺经皮椎体成形术治疗Ⅰ、Ⅱ期Kummell病的临床疗效分析

Analysis on clinical effects of modified and traditional puncture percutaneous vertebroplasty in treating stageⅠandⅡKummell’s disease

目的比较改良与传统穿刺经皮椎体成形术(PVP)治疗Ⅰ、Ⅱ期Kummell病的临床疗效。方法纳入使用PVP治疗的Ⅰ、Ⅱ期Kummell病患者为研究对象,根据穿刺方法将患者分为改良组(22例)和传统组(18例)。分析比较术前及术后不同时期2组患者的临床资料、伤椎椎体前缘高度、腰背部疼痛评分[视觉模拟量表(VAS)]、腰背部功能障碍评分[Oswestry功能障碍指数(ODI)问卷]及骨水泥渗漏并发症发生率。结果与传统组比较,改良组患者注入骨水泥量明显增加(P<0.05),术后6个月、1年椎体前缘高度增加(P<0.05);2组患者术后各时间点的腰背部VAS及ODI问卷评分差异无统计学意义(P>0.05);并发症方面,由于Kummell病病理基础的特殊性,2组均出现不同程度的骨水泥渗漏,但发生率差异无统计学意义(P>0.05)。结论2组不同穿刺技术治疗Ⅰ、Ⅱ期Kummell病均能明显缓解患者腰背部疼痛并提升生活质量,但改良穿刺骨水泥锚定PVP治疗Kummell病注入的骨水泥量较传统穿刺明显增加,术后椎体前缘高度维持较传统穿刺更好。

Objective To compare the clinical effects of modified and traditional puncture percutaneous vertebroplasty(PVP)in treating stageⅠandⅡKummell’s disease.Methods The patients with stageⅠandⅡKummell’s disease treated with PVP were selected as the research subjects and divided into the modified group(22 cases)and traditional group(18 cases)according to the puncture method.The clinical data,anterior edge height of the injured vertebral body,pain score(VAS),dysfunction score(ODI)and bone cement leakage complications during different periods before and after operation were compared between the two groups.Results Compared with the traditional group,the amount of injected bone cement in the modified group was significantly increased(P<0.05),and the anterior edge height of the vertebral body in postoperative 6,12 months was increased(P<0.05);the VAS and ODI scores at each postoperative time point had no statistically significant difference between the two groups(P>0.05).In the aspect of complications,due to the particularity of pathological basis in Kummell’s disease,the two groups appeared different degrees of bone cement leakage,but the difference was not statistically significant(P>0.05).Conclusion The two kinds of different puncture techniques in the treatment of stageⅠandⅡKummell’s disease could significantly alleviate the patients’low back pain and improve the quality of life.However,the infused bone cement amount in modified puncture cement anchoring PVP for treating Kummell’s disease is increased compared with that in traditional puncture,so that the anterior vertebral height maintenance after surgery is better than that in traditional puncture.