靶向穿刺结合分阶段注射PKP治疗老年胸腰段Kümmell's 病临床疗效分析

doi:10.3969/j.issn.1006-6233.2020.03.030

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摘要 目的:探讨靶向穿刺结合分阶段注射技术经皮椎体后凸成形术(PKP)治疗老年Kümmell's病的临床疗效。方法:回顾性分析2007年1月至2018年1月63例单节段老年胸腰段Kümmell's病患者的临床资料,采用靶向穿刺结合分阶段注射技术PKP,比较术前及术后1d、3个月、6个月、12个月VAS评分、椎体后凸角(Cobb角)改善、椎体前缘高度的变化、Oswestry功能障碍指数(Oswestry Disability Index,ODI)、骨水泥渗漏评估临床疗效。结果:本组患者 6例失访,随访率 90.5％。57例患者行双侧椎弓根穿刺技术,成功率100%。随访12~16(平均13.68±1.30)个月,48例腰背部疼痛基本消失,9例疼痛明显减轻。术后1d、3个月、6个月、12个月VAS评分、ODI、Cobb角和椎体前缘高度均较术前明显改善(P<0.05)。骨水泥渗漏:C型4例,B型1例,S型1例,但无椎管内渗漏,未出现临床症状。结论:靶点穿刺结合分阶段注射技术治疗老年Kümmell's病,迅速缓解疼痛,部分恢复椎体高度,改善局部后凸,改善生活质量,能明显降低PKP术中的骨水泥渗漏率,临床效果满意。

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关键词 ： Kümmell's病, 靶向穿刺, 分阶段注射, 经皮椎体后凸成形术, 骨水泥渗漏

Abstract：Objectives: To explore the clinical effects of targeted puncture combined with staged injection of PKP in the treatment of Kümmell's disease in thethoracolumbar vertebral body of the elderly. Methods: The clinical data of 63 single segment elderly patients with thoracolumbar Kümmell's disease from January 2007 to January 2018 were analyzed retrospectively. PKP was used in combination with targeted puncture and staged injection. The VAS score, the improvement of Cobb angle, the change of anterior height, the Oswestry disability index (ODI) and the leakage of bone cement were compared before and 1 day, 3 months, 6 months and 12 months. Results: 6 patients were lost to follow-up, the follow-up rate was 90. 5%. Fifty-seven patients underwent bilateral pedicle puncture, and the success rate was 100%. During the 12-16 months of follow-up (average 13.68±1.30).48 cases of low back pain basically disappeared, and 9 cases of pain significantly reduced. VAS score, ODI, Cobb Angle and vertebral anterior margin height were significantly improved at 1, 3, 6 and 12 months after surgery (P < 0.05). Bone cement leakage: there were 4 cases of type C, 1 case of type B and 1 case of type S, but there was no intraspinal leakage and no clinical symptoms. Conclusion: Targeted puncture combined with staged injection in the treatment ofKümmell's disease in the elderly can rapidly relieve pain, partially restore vertebral height, improve local kyphosis and improve quality of life, and significantly reduce the rate of bone cement leakage during PKP.

Key words： Kümmell's disease Targeted puncture Staged injection Percutaneous kyphoplasty Bone cement leakage

基金资助:河北省承德市科学技术研究与发展计划项目,(编号:201801A007)

通讯作者: 金宝城

引用本文:

赵胜军, 赵丽, 金宝城, 朴海旺. 靶向穿刺结合分阶段注射PKP治疗老年胸腰段Kümmell's 病临床疗效分析[J]. 河北医学, 2020, 26(3): 478-481.
ZHOA Shengjun, et al. Analysis on the Clinical Effect of Targeted Puncture Combined with Staged Injection of PKP in the treatment of Kümmell's Disease in the Thoracolumbar Vertebral Body of the Elderly. HeBei Med, 2020, 26(3): 478-481.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.03.030 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I3/478