Park Jae Won, Park Jong-Hwa, Jeon Hong Jun, Lee Jong Young, Cho Byung Moon, Park Se-Hyuck
Department of Neurosurgery, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Korean J Neurotrauma. 2017 Oct;13(2):119-123. doi: 10.13004/kjnt.2017.13.2.119. Epub 2017 Oct 31.
To evaluate the radiographic and clinical outcomes of percutaneous vertebroplasty (PVP) in patients with Kümmell's disease.
A retrospective review was conducted for 19 vertebrae in 18 patients, between January 2012 and June 2016. A visual analogue scale (VAS) score was used to determine each patient's subjective level of pain (0=no pain to 10=severe pain) preoperative, immediately postoperative and at the last follow-up (at least 12 months after PVP).Radiographic parameters such as regional and global kyphotic angle, lumbar lordosis (LL), thoracolumbar junction (TLJ) angle, vertebral height, cement leakage, refracture, and adjacent level fracture were evaluated by the clinician preoperative, immediate postoperative and at the last follow-up.
The mean VAS score significantly decreased after PVP and the decrease was maintained through to the final follow-up (<0.05). However, the regional and global kyphotic angle, LL, and TLJ angle were not improved. Cement leakage was observed in 5 cases (26.3%): however, there were no cases of cement leakage into the spinal canal. No neurological deterioration was observed, even among patients with cement leakage. Adjacent level fractures were detected in 3 cases (15.8%).
PVP can be considered as an effective treatment option for pain relief and maintenance of sagittal balance in patients with Kümmell's disease.
评估经皮椎体成形术(PVP)治疗Kümmell病患者的影像学和临床疗效。
对2012年1月至2016年6月期间18例患者的19个椎体进行回顾性研究。采用视觉模拟评分法(VAS)在术前、术后即刻及末次随访(PVP术后至少12个月)时评估每位患者的主观疼痛程度(0=无疼痛至10=剧痛)。临床医生在术前、术后即刻及末次随访时评估诸如局部和整体后凸角、腰椎前凸(LL)、胸腰段交界(TLJ)角、椎体高度、骨水泥渗漏、再骨折及相邻节段骨折等影像学参数。
PVP术后VAS评分均值显著降低,且该降低一直持续至末次随访(P<0.05)。然而,局部和整体后凸角、LL及TLJ角并未改善。观察到5例(26.3%)发生骨水泥渗漏:但无骨水泥渗漏至椎管内的病例。即使在发生骨水泥渗漏的患者中也未观察到神经功能恶化。检测到3例(15.8%)发生相邻节段骨折。
PVP可被视为缓解Kümmell病患者疼痛及维持矢状面平衡的有效治疗选择。