经皮椎体后凸成形术治疗椎体裂隙周围硬化的Kümmell病

目的探讨经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗椎体裂隙周围硬化的Kümmell病的安全性与疗效。方法 2011年1月~2013年6月,20例骨质疏松性椎体裂隙周围硬化的Kümmell病患者在本院接受PKP治疗。术前、术后2 d及末次随访时采用疼痛视觉模拟量表(visual analogue scale,VAS)评分及Oswestry功能障碍指数(Oswestry disability index,ODI)评估患者疼痛缓解和生活质量改善情况。测量并记录伤椎前缘相对高度和局部后凸Cobb角的矫正情况。结果本组病例随访12~36个月,平均16个月;无脊髓神经根损伤、肺栓塞等并发症发生。术前VAS评分、ODI、伤椎前缘相对高度和后凸角分别为(8.9±0.4)分、(87.5±3.5)%、(41.3±5.2)%、22.1°±1.8°,术后2 d分别为(2.2±0.6)分、(31.8±4.1)%、(71.2±4.9)%、12.6°±1.4°,末次随访时为(2.0±0.3)分、(26.1±1.3)%、(70.7±4.8)%、13.2°±1.8°,术后2 d与术前相比差异具有统计学意义(P0.05),末次随访与术后2 d相比差异无统计学意义(P0.05)。结论 PKP用于治疗椎体裂隙周围硬化的Kümmell病安全、有效,能缓解疼痛、恢复椎体高度、纠正脊柱后凸畸形,可改善患者生活质量。

Percutaneous kyphoplasty for treatment of Kümmell's disease with sclerosis around intervertebral cleft

Objective To evaluate the therapeutic effect of percutaneous kyphoplasty (PKP) for the treatment of Kümmell's disease with sclerosis around the intervertebral cleft. Methods From January 2011 to June 2013, 20 cases suffering from osteoporotic Kümmell's disease with sclerosis around the intervertebral cleft were treated by PKP. The clinical data were retrospectively analyzed. Visual analogue scale(VAS) scores, Oswestry disability index(ODI), the relative height of anterior border and the Cobb's angle of the involved vertebral body were analyzed at pre-operation, postoperative 2 d and the final follow-up with SPSS13.0 software. Results All patients who were followed up for 12-36 months (mean 16 months), received back pain improvement postoperatively. No complications such as spinal nerve root injury, pulmonary embolism occured. The preoperative VAS scores, ODIs, the relative height of anterior border and Cobb's angle of involved vertebral body were 8.9±0.4, (87.5±3.5)%, (41.3±5.2)%, 22.1°±1.8°, and dropped to 2.2±0.6, (31.8±4.1)%, (71.2±4.9)%, 12.6°±1.4° at postoperative 2 d, respectively. There was significant difference between pre-operation and postoperative 2 d(P<0.05). The data of the final follow-up turned to 2.0±0.3, (26.1±1.3)%, (70.7±4.8)%, 13.2°± 1.8°, with no statistic difference compared to those of postoperative 2 d, respectively (P>0.05). Conclusion PKP has satisfactory efficacy in pain relief, function improvement, the height reconstruction of involved vertebral body and Cobb's angle correction for the patients suffering from osteoporotic Kümmell's disease with sclerosis around the intervertebral cleft.