Zhang Xing, Li Yong-Chao, Liu Hong-Peng, Zhou Bing, Yang Hui-Lin
Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China.
Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.
World J Clin Cases. 2020 Dec 6;8(23):5887-5893. doi: 10.12998/wjcc.v8.i23.5887.
Percutaneous vertebroplasty (PVP) is an effective method for the treatment of neurologically intact Kümmell's disease, but bone cement leakage during surgery is a problem that deserves attention.
To reduce bone cement leakage and evaluate the effect of the sequential infusion of bone cement during PVP for the treatment of stage I or II Kümmell's disease.
Patients with Kümmell's disease treated in our hospital from September 2015 to September 2018 were retrospectively analyzed. Patients meeting the inclusion and exclusion criteria were divided into two groups: Traditional single infusion and sequential infusion (SI). The visual analog scale (VAS) and Oswestry disability index (ODI) were evaluated and compared, and duration of operation, bone cement content and complications were recorded.
Forty-five patients were included in this study; there were 24 in the traditional single infusion group and 21 in the SI group. The VAS and ODI were significantly different for both groups when compared pre- and postoperatively, whereas the differences between 1 wk postoperatively and at the final follow-up were not statistically. When the VAS and ODI of the two groups were compared, there were no significant differences at any time point. The leakage rate of bone cement was significantly lower in the SI group (14.3%, 3 of 21) than that in the traditional single infusion group (41.7%, 10 of 24).
SI in unipedicular PVP is a safe and effective procedure for neurologically intact Kümmell's disease, and this technique could decrease the incidence of bone cement leakage.
经皮椎体成形术(PVP)是治疗神经功能完好的Kümmell病的有效方法,但手术过程中骨水泥渗漏是一个值得关注的问题。
减少骨水泥渗漏,并评估在PVP治疗Ⅰ期或Ⅱ期Kümmell病期间序贯注入骨水泥的效果。
回顾性分析2015年9月至2018年9月在我院接受治疗的Kümmell病患者。符合纳入和排除标准的患者分为两组:传统单次注入组和序贯注入组(SI)。评估并比较视觉模拟量表(VAS)和Oswestry功能障碍指数(ODI),记录手术时间、骨水泥用量及并发症情况。
本研究共纳入45例患者;传统单次注入组24例,SI组21例。两组术前和术后比较,VAS和ODI均有显著差异,而术后1周与末次随访时的差异无统计学意义。两组VAS和ODI在任何时间点比较均无显著差异。SI组骨水泥渗漏率(14.3%,21例中的3例)显著低于传统单次注入组(41.7%,24例中的10例)。
单侧PVP中的序贯注入法是治疗神经功能完好的Kümmell病的一种安全有效的方法,该技术可降低骨水泥渗漏的发生率。