|
|
|
| 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 |
| ZHOA Shengjun, et al |
| The Central Hospital of Chengde, Hebei Chengde 067000, China |
|
|
|
|
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.
|
|
|
|
|
|
[1] Kim YC, Kim YH, Ha KY.Pathomechanism of intravertebral clefts in osteoporotic compression fractures of the spine[J]. Spine,2014,14:659~666.
[2] Hong SJ, Lee S, Yoon JS, et al. Analysis of intradiscal cement leakage during percutaneous vertebroplasty: multivariate study of risk factors emphasizing preoperative MR findings[J].Neuroradiol,2014,41:195~201.
[3] Park JW, Park JH, Jeon HJ,et al.Kümmell's disease treated with percutaneous vertebroplasty: minimum 1 year follow-up[J]. Korean Neurotrauma,2017,13:119~123.
[4] Lim J, Choi SW, Youm JY, et al. Posttraumatic delayed vertebral collapse : kümmell's disease[J].Korean Neurosurg Soc,2018,61:1~9.
[5] Zha LL, Tong PJ, Xia LW, et al.Diagnostic analysis of the radiologic characteristics in osteoporotic Kiinmmel's disease[J]. Zhongguo Gu Shang,2016,29:460~463.
[6] Kim HS, Singh R, Adsul NM, et al.Acute burst fracture in kümmell's disease with acute onset neurological deficit: a case report on role of spinal stability and technical notes on "pivot ligamentotaxis"[J]. BMC Surg,2019,19:49.
[7] 马远征,王以朋,刘强,等.中国老年骨质疏松症诊疗指南(2018)[J].中国骨质疏松杂志,2018,24(12):1541~1567.
[8] Chen L, Dong R, Gu Y, et al.Comparison between balloon kyphoplasty and short segmental fixation combined with vertebroplasty in the treatment of Kümmell's disease[J]. Pain Physician,2015,18:373~381.
[9] Kim HS, Heo DH. Percutaneous pedicle screw fixation with polymethy imethacrylate augmentation for the treatment of thoracolumbar intravertebral pseudoarthrosis associated with kümmell's osteonecrosis[J]. Biomed Res Int, 2016, 2016: 3878063.
[10] Wang F, Wang D, Tan B, et al. Comparative study of modified posterior operation to treat Kümmell's disease[J]. Medicine (Baltimore),2015,94(39): e1595.
[11] Ren H, Wang J, Chen J, Jiang J.Clinical efficacy of unipedicular versus bipedicular percutaneous vertebroplasty for Kümmell's disease[J]. Nan Fang Yi Ke Da Xue Xue Bao,2014,34:1370~1374. |
|
|
|
2020, Vol. 26 
