摘要
目的:探讨球囊扩张椎体后凸成形术治疗骨质疏松性Kummell病的疗效。方法:2010年5月至2012年2月对8例骨质疏松性Kummell病患者行球囊扩张椎体后凸成形术治疗,男2例,女6例;年龄67～83岁,平均73.4岁;腰背部疼痛病史2个月～3年,站立时疼痛难忍,卧床后减轻,严重影响日常生活。其中Ⅰ度1例,Ⅱ度4例,Ⅲ度3例,伴有脊髓神经症状者除外。术前摄X线片,行CT、MRI影像学检查,均提示胸腰段椎体压缩性骨折,病椎可见线形透亮线、真空裂缝征及与其相对应的液体信号区域。术前、术后第2天及末次随访时摄站立位X线侧位片测椎体前柱高度及Cobb角,并采用视觉模拟评分(visualanalogue scale,VAS)、日本骨科协会评分(Japanese Orthopedic Association,JOA)及Oswestry功能障碍指数(ODI)综合评估手术疗效。结果:术后患者伤口均Ⅰ期愈合,无感染及愈合不良。所有患者术后疼痛减轻明显,离床时间1～10d,平均4.3d。1例发生骨水泥椎间盘渗漏,随访期间未出现临床症状。侧位X线片示病椎前柱高度及Cobb角分别由术前(30.4±7.4)%和(31.3±9.9)°恢复至术后第2天(70.3±3.3)%和(9.1±3.0)°,VAS及JOA评分、ODI分别由术前的8.7±1.2、12.3±1.7和(93.3±4.6)%改善至术后第2天的3.1±1.1、24.9±1.6和(32.2±5.4)%。8例均得到随访,时间3～24个月,平均4.7个月,末次随访时侧位X线片示病椎前柱高度及Cobb角分别为(69.9±3.2)%、(10.9±2.4)°,VAS和JOA评分、ODI分别为2.2±1.0、26.4±1.4和(29.2±4.5)%,与术后第2天比较差异均无统计学意义。结论:球囊扩张椎体后凸成形术是治疗骨质疏松性Kummell病的有效方法之一。
Objective：To explore the clinical efficacy of the percutaneous kyphoplasty for the treatment of osteoporotic Kummell＇s disease. Methods：From May 2010 to February 2012,8 patients with osteoporotic Kummell＇s disease were treated with percutaneons balloon kyphoplasty. There were 2 males and 6 females, with a mean age of 73.4 years. All the patients suf- fered from lower back pain for 4.7 months ,which affected seriously the patient＇s quality of life. The anterior vertebral height and Cobb angel was measured on standing lateral radiograph at pre- and post-operatively （2 days after operation ）and during the final follow-up. Visual analog scale（VAS） ,Japanese Orthopedic Association （JOA） and Oswestry disability index （ODI） were used to evaluate pain and function. Results： Incision of all patients healed normally without infection. The level of back pain decreased remarkably after surgery. The mean time of ambulation was 4.3 days （ranged, 1 to 10 days）. Cement leakage oc- curred in 1 case with no symptom. The anterior vertebral height and Cobb angel of the fractured vertebra recovered respectively from preoperative（30.4±7.4）% and （31.3±9.9） degree to （70.3±3.3）% and （9.1±3.0） degree at the 2nd day after operation. VAS and JOA seores,ODI improved from preoperative 8.7±1.2,12.3±1.7 and （93.3±4.6）% to 3.1±1.1,24.9±1.6 and （32.2± 5.4）% respectively at the 2nd day after operation. All the patients were followed up,and the duration ranged from 3 to 24 months,with a mean of 4.7 months. At the latest follow-up, the anterior vertebral height and Cobb angel of the fractured verte- bra were （69.9±3.2）% and（ 10.9±2.4）degree ; the VAS and JOA scores and ODI were 2.2±1.0,26.4±1.4 and（29.2±4.5）% re- spectively ,which had no obvious difference compared to those results at the 2nd day after operation. Conclusion： Balloon kyphoplasty is safe and effective treatment for osteoporotic Kummell＇s disease.
出处
《中国骨伤》
CAS
2013年第5期429-434,共6页
China Journal of Orthopaedics and Traumatology
关键词
骨折
胸椎
腰椎
骨质疏松
Fractures
Thoracic vertebrae
Lumbar vertebrae
Osteoporosis
