Department of Spine Surgery, Luoyang Orthopedic Hospital of Henan Province, South Qiming Road, Luoyang, China.
Medicine (Baltimore). 2021 Jun 4;100(22):e25996. doi: 10.1097/MD.0000000000025996.
Kummell's disease is a delayed vertebral collapse fracture caused by posttraumatic osteonecrosis. It is a special type of osteoporotic vertebral fracture in the elderly. This study compares and analyzes the difference in the curative effect of 2 kinds of osteoporotic vertebral compression fracture (OVCF) in the presence of fracture or not in the vertebral body, and provides a clinical reference for the application of percutaneous kyphoplasty (PKP).This research is a kind of retrospective analysis from January 2012 to January 2015, PKP was used to treat 165 patients with osteoporotic vertebral compression fracture. The patients were divided into 2 groups: Intravertebral clefts group (group A) and none-intravertebral clefts group in vertebral body (group B). Bone mineral density (BMD), bone cement injection (BCI), Visual analogue scale (VAS) score before and after surgery, anterior, central and posterior height of vertebral body (before and after surgery) and Cobb angle of injured vertebra (before and after surgery) were compared between the 2 groups.Surgeries for 165 patients in the 2 groups were successfully completed, and 226 fractured vertebrae were performed through bilateral puncture approach to strengthen the vertebral body. Intraoperative injection of bone cement (ml) was 4.25 + 1.29 (range: 2.6-7.8). There were statistically significant differences in bone cement injection quantity between the 2 groups (P < .05), and in bone cement leakage (P > .05) as well as the Postoperative VAS score (P < .05). However, There was no statistical difference in VAS score before surgery between the 2 groups (P > .05). The results indicated that the pain relief degree of OVCF patients without intravertebral clefts is better than that in the vertebral body. No statistical difference was found in Cobb Angle before and after surgery (P > .05), as well as the correction rate of the injured vertebrae before and after surgery (P > .05). There was no statistical difference in the degree of recovery of the anterior, middle and posterior margins of the injured vertebrae after surgery (P > .05).PKP treatment led to better degree of pain relief in OVCF patients without intravertebral clefts, and less bone cement was injected into the surgery.
克氏病是一种由创伤后骨坏死引起的迟发性椎体塌陷骨折,是老年人骨质疏松性椎体骨折的一种特殊类型。本研究比较分析了伴有和不伴有椎体骨折的 2 种骨质疏松性椎体压缩骨折(OVCF)的疗效差异,为经皮椎体后凸成形术(PKP)的应用提供了临床参考。本研究为 2012 年 1 月至 2015 年 1 月的回顾性分析,采用 PKP 治疗 165 例骨质疏松性椎体压缩骨折患者。将患者分为 2 组:椎体内裂隙组(A 组)和无椎体内裂隙组(B 组)。比较两组患者术前、术后骨密度(BMD)、骨水泥注入量(BCI)、视觉模拟评分(VAS)、椎体前缘、中央、后缘高度(术前、术后)及伤椎 Cobb 角(术前、术后)。两组共 165 例患者手术均顺利完成,均采用双侧经皮穿刺入路强化椎体,术中骨水泥注入量(ml)为 4.25+1.29(范围:2.6-7.8)。两组间骨水泥注入量差异有统计学意义(P<0.05),骨水泥渗漏差异无统计学意义(P>0.05),术后 VAS 评分差异有统计学意义(P<0.05),但两组术前 VAS 评分差异无统计学意义(P>0.05)。两组术后 Cobb 角差异无统计学意义(P>0.05),伤椎前后、左右侧位矫正率差异无统计学意义(P>0.05),术后伤椎前缘、中部、后缘高度恢复程度差异无统计学意义(P>0.05)。PKP 治疗可使不伴有椎体内裂隙的 OVCF 患者疼痛缓解程度更好,术中注入的骨水泥量更少。