Zhao Ji-Peng, Sun Chuan, Xiang Xue-Qiang, Liu Zhen-Hui, Wu Hai-An, Du Sheng-Yang
Department of Orthopaedics, the First People's Hospital of Xuzhou, Xuzhou 221006, Jiangsu, China.
Zhongguo Gu Shang. 2021 Feb 25;34(2):170-4. doi: 10.12200/j.issn.1003-0034.2021.02.015.
To explore clinical effect of cement-augmented pedicle screw combined with vertebroplasty in treating Kümmell disease with type Ⅲ.
From January 2015 to December 2018, 37 patients with type Ⅲ Kümmell disease were retrospectively analyzed, including 11 males and 26 females, aged from 61 to 84 years old with an average of (68.6±4.2) years old, and the courses of disease ranged from 2 to 10 months with an average of(6.5±2.3) months. Nine patients were grade C, 20 patients were grade D and 8 patients were grade E according to Frankle grading. All patients were treated by cement-augmented pedicle screw combined with vertebroplasty. Operation time, blood loss, postoperative drainage, hospital stay and complicationswere observed after oeprtaion. Visual analogue scale(VAS), Oswestry Disability Index(ODI), height of anterior vertebral body, Cobb angle before and after operation were compared.
All patients were followed up from 12 to 60 months with an average of (22.4±10.9) months. Operation time was (240.9±77.4) min, blood loss was (315.0±149.2) ml, postoperative drainage was (220.8±72.0) ml, hospital stay was (12.6±4.7) days. One patient occurred incision redness and 1 patient occurred infection after opertaion. No loosening of bone cement occurred. Postopertaive VAS and ODI were lower than that of before opertaion(<0.05), height of anterior vertebral body after opertaion was larger than that of before opertaion, Cobb angle after operation was less than that of before operation (<0.05). According to Frankle grading of never function at the latest follow up, 2 patients were grade D and 35 patients were grade E. Nerve function and quality of life was improved.
Cement-augmented pedicle screw combined with vertebroplasty is a safe and effective method for the tretament of Kümmell disease with type Ⅲ.
探讨骨水泥强化椎弓根螺钉联合椎体成形术治疗Ⅲ型Kümmell病的临床疗效。
回顾性分析2015年1月至2018年12月收治的37例Ⅲ型Kümmell病患者，其中男11例，女26例；年龄61～84岁，平均（68.6±4.2）岁；病程2～10个月，平均（6.5±2.3）个月。Frankle分级：C级9例，D级20例，E级8例。所有患者均采用骨水泥强化椎弓根螺钉联合椎体成形术治疗。观察手术时间、出血量、术后引流量、住院时间及并发症情况。比较术前、术后视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、椎体前缘高度、Cobb角。
所有患者均获随访，随访时间12～60个月，平均（22.4±10.9）个月。手术时间（240.9±77.4）min，出血量（315.0±149.2）ml，术后引流量（220.8±72.0）ml，住院时间（12.6±4.7）d。术后1例切口发红，1例感染，未发生骨水泥松动。术后VAS、ODI均低于术前（P<0.05），椎体前缘高度高于术前，Cobb角小于术前（P<0.05）。末次随访时按Frankle神经功能分级，D级2例，E级35例，神经功能及生活质量均改善。
骨水泥强化椎弓根螺钉联合椎体成形术是治疗Ⅲ型Kümmell病的一种安全有效的方法。
