PKP治疗Kummell病骨水泥渗漏影像及临床疗效观察

目的观察经皮椎体后凸成形术(PKP)治疗Kummell病时骨水泥渗漏情况,探讨手术疗效及安全性。方法回顾性分析自2013-06—2016-01采用PKP治疗的27例(27椎)Kummell病,按是否出现骨水泥渗漏分为渗漏组(15例)与未渗漏组(12例)。比较2组术后2 d、末次随访时VAS评分、ODI指数,以及末次随访时伤椎前缘高度恢复值、伤椎中部高度恢复值、伤椎后缘高度恢复值及伤椎Cobb角改善值。结果 27例(27椎)中出现骨水泥渗漏15例(15椎),但均未出现明显症状,骨水泥渗漏率为55.6%。渗漏组获得(12.6±2.6)个月随访,未渗漏组获得(11.9±3.1)个月随访。2组术后2d、末次随访时VAS评分及ODI指数比较差异无统计学意义(P0.05)。2组末次随访时伤椎前缘高度恢复值、伤椎中部高度恢复值、伤椎后缘高度恢复值及伤椎Cobb角改善值差异无统计学意义(P0.05)。结论 PKP治疗Kummell病骨水泥渗漏率较高,但手术安全可靠。术中应采用多种方法避免骨水泥渗漏,且不能忽视骨水泥渗漏带来的风险。

Imaging and clinical observation of cement leakage in PKP for Kummell disease

Objective To analyze the position of cement leakage in Kummell patients treated with percutaneous kyphoplasty (PKP),and to investigate the efficacy and safety of PKP treating Kummell disease.Methods Twenty-seven Kummell patients with 27 diseased vertebrae receiving PKP surgery from June 2013 to January 2016,were divided into leakage group(15 cases) and no leakage group (12 cases),and retrospectively analyzed.The anterior,middle,posterior height and the improvement Cobb of diseased vertebrae,VAS,and ODI two days after PKP and at final follow up were all statistically analyzed.Results There were no obvious symptom,although 15 bone cement leakage cases (15 vertebrate) occurred in 27 cases (27 vertebrate).The bone cement leakage rate was 55.6％.The leakage group was followed up for (12.6±2.6)months,and the non leakage group was followed up for (11.9±3.1)months.There was no significant difference in VAS score and ODI index between the 2 groups two days after PKP and at last follow-up(P ＞0.05).There was no significant difference between the 2 groups at the last follow-up in the recovery of the anterior edge,middle height,and back edge of the injured vertebra,and the improvement of the Cobb angle of the injured vertebrate(P ＞0.05).Conclusion Although PKP has high bone cement leakage rate in Kummell disease,the operation is safe and reliable.A variety of methods should be adopted to avoid bone cement leakage,and the risk of bone cement leakage can not be ignored.