过伸体位单侧经皮椎体后凸成形术治疗老年Ⅰ、Ⅱ型Kummell病

Unilateral percutaneous kyphoplasty in the treatment of typeⅠ,Ⅱ Kummell disease in hyperextension position

目的探讨过伸体位单侧经皮椎体后凸成形术(PKP)治疗老年Ⅰ、Ⅱ型Kummell病的疗效。方法将36例老年Ⅰ、Ⅱ型Kummell病患者根据体位不同分为观察组(采用过伸体位单侧PKP治疗,18例19椎)和对照组(采用常规单侧PKP治疗,18例22椎)。记录两组手术情况、疼痛VAS评分、椎体前缘高度比、后凸角以及并发症发生情况。结果患者均获得1个月随访。手术时间、骨水泥注入量两组比较差异均无统计学意义(P>0.05)。术后24 h、30 d疼痛VAS评分:两组均低于术前(P<0.05),两组比较差异均无统计学意义(P>0.05)。术后24 h、30 d椎体前缘高度比:两组均大于术前(P<0.05),观察组均大于对照组(P<0.01)。术后24 h、30 d后凸角:两组均小于术前(P<0.05),观察组均小于对照组(P<0.01)。患者均未发生神经根、脊髓马尾以及血管损伤,术后无感染、静脉栓塞、骨水泥渗漏等情况。结论与常规单侧PKP治疗相比,过伸体位单侧PKP治疗老年Ⅰ、Ⅱ型Kummell病骨折复位效果更好。

Objective To investigate the curative effect of unilateral percutaneous kyphoplasty(PKP)in hyperextension position on typeⅠ,ⅡKummell disease in the elderly.Methods The 36 elderly patients with typeⅠ,ⅡKummell disease were divided into observation group(18 patients with 19 vertebrae were treated with unilateral PKP in hyperextension position)and control group(18 patients with 22 vertebrae were treated with conventional unilateral PKP).The surgical status,pain VAS,vertebral anteriormargin height ratio,kyphotic angle and complications were recorded in the two groups.Results All patients were followed up for1 month.There were no statistical differences in operation time and bone cement injection volume between the two groups(P>0.05).At 24 h and 30 d aftersurgery,pain VAS were lowerthan those before surgery(P<0.05),and there was no statistical difference between the two groups(P>0.05).At 24 h and 30 d aftersurgery,the vertebral anteriormargin height ratio of two groups were higherthan the preopration(P<0.05),and the observation group was largerthan the control group(P<0.01).The kyphotic angle was lowerin both groups at 24 h and 30 d aftersurgery than before surgery(P<0.05),the observation group was lowerthan that in control group(P<0.01).There were no injuries of nerve root,spinal cord cauda equina and blood vessels,infection,venous embolism,bone cement leakage.Conclusions Compared with the conventional PKP treatment,hyperextension position unilateral PKP in the treatment of ederly typeⅠ,ⅡKummell disease has bettercurative effect.