经皮椎体成形术治疗胸腰段椎体Kummell病

目的：探讨经皮椎体成形术治疗Kummell病的适应证，评价单侧入路经皮椎体成形在Kummell病中的应用及其疗效。方法：2009年3月～2011年3月56例Kummell病患者，其中男17例，女39例，平均62．8岁。术前CT测量“真空样”改变的体积、位置；椎体椎弓根轴线与椎弓根骨性穿刺点与椎体“真空样”改变处连线的夹角，确定穿刺方向。术前、术后3d及末次随访时采用VAS评分评价疼痛情况，应用X线片评价骨水泥以及骨折椎体情况。结果：随访15—37个月，平均25．4个月，骨水泥位置良好，病变椎体无再骨折，骨水泥与椎体界面无透亮区。VAS评分术前7．6±0．8、术后3d 2．3±0．6，差异有统计学意义（P〈0．05）；末次随访时2．2±0．5，与术前比较差异有统计学意义（P〈0．01）。结论：单侧经皮椎体成形技术治疗Kummell病快速、安全、可靠。确定责任椎体以利于适应证的选择，准确的影像学测量有利于穿刺的准确性。

Percutaneous vertebroplasty for treatment of Kummell disease

Objective： To investigate the indications of percntaneous vertebroplasty for treatment of Kummell disease, and to evaluate the efficacy of unilateral percutaneous vertebroplasty. Methods： From March 2009 to March 2011, 56 osteoporotic Ktimmell patients, including 17 male and 39 female, aging from 55-72 years （mean 62.8 years）, underwent posterior unilateral percutaneous vertebroplasty. Before surgery, location and size of the ＂vacuum＂ change were measured by CT, the angle of vertebral pedicle axis, the connection between the bone puncture point of the pedicle and the vertebral ＂vacuum＂ change was measured to determine the direction of puncture. VAS score for pain was carried out, the status of injured vertebra and bone cement （dispersion, location） was evaluated by X-ray pre-op, the third POD and the last follow-up. Results： Patients were followed up for mean 25.4 months （form 15 to 37 months）. Position of bone cement was good, no re-fracture happed on injured vertebra, no lucent area noted between bone cement and vertebral body interface. VAS score was 7.6±0.8 and 2.3±0.6 before and after operation respectively with a significant difference （P〈0.05）, and was 2.2±0.5 at the last follow-up and the difference was statistically significant （P〈0.01）. Conclusion： Unilateral Percutaneous vertebroplasty for treatment of Ktimmell disease is rapid, safe and reliable. Determining responsibility vertebra can conducive to the choice of indications, and accurate imaging measurement can profit exact location of puncture.