| 摘要: |
| ［摘要］ 目的 探讨优化经皮椎体成形术治疗骨质疏松性椎体骨折不愈合（Kümmell病）的临床疗效。方法 回顾性分析2021年1月至2024年1月同济大学附属上海市第四人民医院脊柱外科收治的经皮椎体成形术治疗的153例Kümmell病患者的临床资料，以常规处理的78例为对照组，经交叉穿刺、明胶海绵填塞、人工骨填塞、骨水泥拖尾及真空裂隙新鲜化等优化措施处理的75例为观察组。收集术前、术后3 d、术后1个月、术后3个月、术后6个月及术后12个月腰背部疼痛视觉模拟量表（VAS）评分和Oswestry功能障碍指数（ODI）、伤椎前缘高度、伤椎上下终板所成角及胸腰段Cobb角等指标数据进行比较分析。结果 两组术后各时间点VAS评分及ODI与术前相比均显著降低（P<0.05），但组间差异无统计学意义（P>0.05）。两组术后各时间点伤椎前缘高度、伤椎上下终板所成角及胸腰段Cobb角与术前相比均显著改善（P<0.05），观察组改善更明显（P<0.05）。观察组并发症发生率低于对照组，差异有统计学意义（2.7% vs 25.6%； χ2=16.392，P<0.001）。结论 优化经皮椎体成形术可增强骨水泥锚定、恢复并维持伤椎高度，显著缓解Kümmell病患者腰背部疼痛，改善腰椎功能，提高生活质量。 |
| 关键词: 骨质疏松症 椎体压缩骨折 经皮椎体成形术 Kümmell病 |
| DOI：10.3969/j.issn.1674-3806.2026.02.07 |
| 分类号:R 681.5 |
| 基金项目:上海市虹口区卫生健康委员会临床重点专科项目（编号：HKLCZD2024B03） |
|
| Assessment of the clinical effect of optimized percutaneous vertebroplasty in treatment of Kümmell′s disease |
|
LIU Tao, ZHI Zhongzheng, ZHOU Fuchao, ZHANG Rongcheng, PAN Weicheng, KANG Jian, MIAO Jinhao, HE Zhimin
|
|
Department of Spinal Surgery, Shanghai Fourth People′s Hospital, Tongji University, Shanghai 200434, China
|
| Abstract: |
| ［Abstract］ Objective To explore the clinical effect of optimized percutaneous vertebroplasty(PVP) in treatment of osteoporotic vertebral fracture nonunion(Kümmell′s disease, KD). Methods A retrospective analysis was conducted on the clinical data of 153 patients with KD who underwent PVP in the Department of Spinal Surgery of Shanghai Fourth People′s Hospital, Tongji University from January 2021 to January 2024. Among the patients, 78 patients receiving conventional PVP were assigned to the control group, while the other 75 patients receiving optimized PVP(including cross-puncture, filling with gelatin sponge and artificial bone, bone cement trailing and vacuum intravertebral cleft freshness) were assigned to the observation group. The Visual Analogue Scale(VAS) scores for assessing low back pain and the Oswestry Disability Index(ODI), the vertebral body height of the injured vertebrae, the angles formed between the upper endplate and the lower endplate of the injured vertebrae, and the thoracolumbar Cobb angles were collected before the operation, and at 3 days, 1 month, 3 months, 6 months and 12 months after the operation for comparative analysis. Results The VAS scores and ODI in the two groups at each time point after the operation were significantly lower than those before the operation(P<0.05), but there were no significant defferences between the two groups(P>0.05). The vertebral body height of the injured vertebrae, the angles formed between the upper endplate and the lower endplate of the injured vertebrae, and the thoracolumbar Cobb angles in the two groups at each time point after the operation were significantly improved compared with those before the operation(P<0.05), and the improvement in the observation group was more significant(P<0.05). The incidence of complications in the observation group was lower than that in the control group, with a statistically significant difference between the two groups(2.7% vs 25.6%; χ2=16.392, P<0.001). Conclusion The optimized PVP can enhance bone cement anchoring, restore and maintain the vertebral height of the injured vertebrae, and significantly alleviate back pain in the KD patients, improve their lumbar function and quality of life. |
| Key words: Osteoporosis Vertebral compression fracture Percutaneous vertebroplasty(PVP) Kümmell′s disease(KD) |
