[Kümmell病的临床治疗进展]
[Progress on clinical treatment of Kümmell's disease].
作者信息
Li Jiang-Bi, Na Shi-Bo, Gong Wei-Quan, Lyu Zhen-Shan, Liu Lidi, Zhang Shao-Kun
机构信息
Department of Spinal Surgery, the First Hospital of Jilin University, Changchun 130021, Jilin, China.
出版信息
Zhongguo Gu Shang. 2020 Jan 25;33(1):81-6. doi: 10.3969/j.issn.1003-0034.2020.01.016.
Kümmell's disease is a delayed complication of osteoporotic vertebral compression fracture (OVCF) . The disease can occur months or even years after the initial spinal injury. Unlike the common osteoporotic compression fracture, it develops slowly and causes intractable pain or neurological dysfunction due to intraspinal instability. So far, the pathogenesis of Kümmell's disease has not been completely clear, there is no standard treatment or single effective treatment for Kümmell's disease. The effect of conservative treatment is often not good. Minimally invasive treatment has become the main treatment for patients with Kümmell's disease due to its short operation time, small trauma and exact effect. However, there are complications such as leakage of bone cement and delayed displacement of bone cement. Moreover, minimally invasive treatment is not suitable for all types of Kümmell's disease patients. Patients with posterior cortical fracture and spinal cord compression need to be opened Radiotherapy, whether anterior or posterior, has the disadvantages of long operation time, large trauma and high treatment cost. This article reviews the progress in the treatment of Kümmell's disease to provide guidance for clinical treatment.
Kümmell病是骨质疏松性椎体压缩骨折(OVCF)的一种延迟并发症。该病可在初次脊柱损伤数月甚至数年之后发生。与常见的骨质疏松性压缩骨折不同,它发展缓慢,由于脊柱内不稳定而导致顽固性疼痛或神经功能障碍。迄今为止,Kümmell病的发病机制尚未完全明确,对于Kümmell病尚无标准治疗方法或单一有效的治疗手段。保守治疗效果往往不佳。微创治疗因其手术时间短、创伤小、效果确切,已成为Kümmell病患者的主要治疗方式。然而,存在骨水泥渗漏和骨水泥延迟移位等并发症。此外,微创治疗并不适用于所有类型的Kümmell病患者。伴有后皮质骨折和脊髓受压的患者需要进行开放手术。放疗无论采用前路还是后路,都存在手术时间长、创伤大及治疗费用高的缺点。本文综述了Kümmell病的治疗进展,为临床治疗提供指导。