摘要
背景:经皮椎体后凸成形是治疗Kummell病的一种有效手段,但骨水泥注射剂量多少目前还缺乏统一的标准。目的:探讨单侧经皮椎体后凸成形治疗Kummell病与骨水泥灌注量之间的关系。方法:选择2014年1月至2018年6月无锡市中医医院收治的35例Kummell病患者,其中男11例,女24例,根据骨水泥注入量分两组进行单侧椎体后凸成形治疗,低剂量组(n=16)骨水泥注射量≤3 mL,常规剂量组(n=19)骨水泥注射量≥3 mL且≤6 mL,术中观察骨水泥渗漏情况。术后观察椎体再骨折发生情况;术前、术后2天及末次随访时,采用目测类比评分与Oswestry功能障碍指数评分评估手术疗效,通过影像学评估椎体后凸Cobb角及伤椎椎体前缘高度。试验方案已经通过无锡市中医医院伦理委员会批准。结果与结论:①所有患者均成功完成手术,完成6-36个月术后随访;②术后第2天与末次随访时,两组的目测类比评分与Oswestry功能障碍指数评分均明显低于术前(P<0.05),两组间目测类比评分与Oswestry功能障碍指数评分比较差异无显著性意义(P>0.05);③术后第2天与末次随访时,两组的椎体后凸Cobb角及伤椎椎体前缘高度较术前均明显改善(P<0.05),两组间椎体后凸Cobb角及伤椎椎体前缘高度比较差异无显著性意义(P>0.05);④常规剂量组5例发生骨水泥渗漏、2例发生椎体再骨折,低剂量组1例发生骨水泥渗漏、2例发生椎体再骨折,两组间骨水泥渗漏与椎体再骨折发生比较差异无显著性意义(P>0.05);⑤结果表明,单侧椎体后凸成形治疗Kummell病注射不同剂量的骨水泥均可有效止痛,骨水泥渗漏率与安全性无差异。
BACKGROUND: Percutaneous kyphoplasty is an effective method to treat Kummell’s disease, but there is no uniform standard for the amount of injected bone cement. OBJECTIVE: To investigate the relationship between unilateral percutaneous kyphoplasty for treating Kummell’s disease and the amount of injected bone cement. METHODS: Totally 35 cases of Kummell’s disease, who were treated in the Wuxi Hospital of Traditional Chinese Medicine from January 2014 to June 2018, were included in this study, including 11 males and 24 females. According to bone cement injection volume, unilateral percutaneous kyphoplasty was performed in two groups: Low volume group(n=16;volume ≤ 3 mL) and conventional quantity group(n=19;3 mL ≤ volume ≤ 6 mL). The leakage of bone cement was observed during operation. Vertebral body refracture was postoperatively observed. Visual analogue scale and Oswestry dysfunction index were used to evaluate the efficacy of the surgery preoperatively, 2 days postoperatively and at last follow-up. Vertebral kyphotic Cobb’s angle and the height of injured vertebral anterior edge were assessed by imaging. This study was approved by the Ethics Committee of Wuxi Hospital of Traditional Chinese Medicine. RESULTS AND CONCLUSION:(1) All patients successfully completed the operation, and were followed up for 6-36 months.(2) Visual analogue scale scores and Oswestry dysfunction index of the two groups 2 days after treatment and at final follow-up were significantly lower than those before surgery(P < 0.05). However, there was no significant difference in visual analogue scale scores and Oswestry dysfunction index between the two groups(P > 0.05).(3) Cobb’s angle of vertebral kyphosis and the height of the anterior edge of injured vertebral bodies were significantly improved in the two groups 2 days after treatment and at final follow-up(P < 0.05), but there was no significant difference between the two groups(P > 0.05).(4) In the conventional quantity group, cement leakage occurred in 5 cases and vertebral body refracture occurred in 2 cases. In the low volume group, cement leakage occurred in 1 case and vertebral body refracture occurred in 2 c ases. The incidences of bone cement leakage and vertebral body refracture had no significant difference between the two groups(P > 0.05).(5) The results showed that unilateral percutaneous kyphoplasty could effectively relieve pain with different amounts of bone cement in Kummell’s disease, and there was no difference in leakage rate and safety of bone cement.
作者
任义德
张亚峰
李锋
高宏文
Ren Yide;Zhang Yafeng;Li Feng;Gao Hongwen(Department of Orthopedics,Wuxi Huishan District Hospital of Traditional Chinese Medicine,Wuxi 214000,Jiangsu Province,China;Department of Orthopedics,Wuxi Hospital of Traditional Chinese Medicine,Wuxi 214000,Jiangsu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第16期2467-2472,共6页
Chinese Journal of Tissue Engineering Research
基金
国家自然科学基金面上项目(81473693)，项目负责人：张亚峰~~
