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经皮椎体后凸成形术与骨水泥增强短节段椎弓根螺钉固定治疗 Kümmell 病的比较。

Comparison of Percutaneous Kyphoplasty and Bone Cement-Augmented Short-Segment Pedicle Screw Fixation for Management of Kümmell Disease.

机构信息

Xi'an Medical Uniyersity, Xi'an, Shaanxi, China (mainland).

Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China (mainland).

出版信息

Med Sci Monit. 2018 Feb 21;24:1072-1079. doi: 10.12659/msm.905875.

Abstract

BACKGROUND The purpose of this study was to compare the efficacy of percutaneous kyphoplasty (PKP) and bone cement-augmented short segmental fixation (BCA+SSF) for treating Kümmell disease. MATERIAL AND METHODS Between June 2013 and December 2015, 60 patients were treated with PKP or BCA+SSF. All patients were followed up for 12-36 months. We retrospectively reviewed outcomes, including Oswestry Disability Index (ODI), visual analogue scale (VAS), and kyphotic Cobb angle. RESULTS VAS, ODI, and Cobb angle, measured postoperatively and at the final follow-up, were lower than those measured preoperatively in both groups (P<0.05). VAS, ODI, and Cobb angle measured postoperatively demonstrated no significant differences when compared with those measured at the final follow-up in the PKP group (P>0.05). In the BCA+SSF group, VAS and ODI at the final follow-up were lower than those measured postoperatively (P<0.05), but no significant difference was found in the Cobb angle (P>0.05). The PKP group had better VAS and ODI than the BCA+SSF group, postoperatively (P<0.05). No significant difference was found in VAS and ODI at the final follow-up (P>0.05) or the Cobb angle measured postoperatively and at the final follow-up (P>0.05) between the 2 groups. Operative time, blood loss, and hospital stay in the PKP group were lower than those in the BCA+SSF group (P<0.05). No significant difference was found in complications (P>0.05). CONCLUSIONS PKP patients had better early clinical outcomes, shorter operation times and hospital admission times, and decreased blood loss, but had similar complications, radiographic results, and long-term clinical outcomes compared with BCA+SSF patients.

摘要

背景

本研究旨在比较经皮椎体后凸成形术(PKP)和骨水泥增强短节段固定(BCA+SSF)治疗 Kümmell 病的疗效。

材料与方法

2013 年 6 月至 2015 年 12 月,采用 PKP 或 BCA+SSF 治疗 60 例 Kümmell 病患者。所有患者均随访 12-36 个月。回顾性分析两组患者的疗效,包括 Oswestry 功能障碍指数(ODI)、视觉模拟评分(VAS)和后凸 Cobb 角。

结果

两组患者术后及末次随访时的 VAS、ODI 和 Cobb 角均低于术前(P<0.05)。PKP 组术后 VAS、ODI 与末次随访时比较,差异无统计学意义(P>0.05)。BCA+SSF 组末次随访时 VAS 和 ODI 低于术后(P<0.05),但 Cobb 角差异无统计学意义(P>0.05)。PKP 组术后 VAS 和 ODI 优于 BCA+SSF 组(P<0.05)。末次随访时 VAS 和 ODI 差异无统计学意义(P>0.05),术后及末次随访时 Cobb 角差异无统计学意义(P>0.05)。PKP 组手术时间、术中出血量及住院时间均低于 BCA+SSF 组(P<0.05)。两组患者并发症发生率比较差异无统计学意义(P>0.05)。

结论

PKP 组患者具有更好的早期临床疗效、更短的手术时间和住院时间,出血量更少,但与 BCA+SSF 组患者比较,并发症、影像学结果及长期临床疗效相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae7b/5829537/040ba28de50d/medscimonit-24-1072-g001.jpg

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