Huang Zhao-Bo, Yan Shao-Feng, Li Sheng-Yun, Liu Jun-Hui, Fan Shun-Wu, Zhao Feng-Dong
Department of Orthopaedics, Sir Run Run Shaw Hospital Affiliated to Zhejiang University, Hangzhou 310016, Zhejiang, China.
Zhongguo Gu Shang. 2021 Aug 25;34(8):694-700. doi: 10.12200/j.issn.1003-0034.2021.08.002.
To explore the clinical effects of posterior short-segment pedicle screw internal fixation combined with vertebroplasty for the treatment of Kümmell disease with kyphosis.
Twenty-four patients with Kümmell disease complicated with kyphosis treated by posterior short-segment pedicle screw internal fixation combined with vertebroplasty from January 2016 to December 2018 were retrospectively analyzed, including 6 males and 18 females, aged 63 to 85 (73.1±6.5) years old. The clinical effect was evaluate by visual analogue scale (VAS), Oswestry Disability Index (ODI), the anterior height of injured vertebral body, and the sagittal Cobb angle of the affected segment beforeoperation, at 3 days and final follow up after operation. And the surgical complications were observed.
All 24 patients were followed up from 12 to 24 months with an average of (15.5±3.2) months. The VAS score was decreased from 5.21±1.06 preoperatively to 2.38±0.58 at 3 days postoperatively and 1.71±0.75 at final follow-up;ODI was decreased from (50.4±13.5)% preoperatively to (20.9±8.0)% at 3 days postoperatively and (16.7±9.6)% at final follow-up;the anterior height of injured vertebral body was restored from (8.0±4.2) mm before surgery to (18.1±5.0) mm at 3 days after surgery and (16.8±5.1) mm at final follow up;the sagittal Cobb angle of affected segment was decreased from (19.5±6.3)° preoperatively to (7.6±2.1)° at 3 days after surgery and(8.4±1.7)° at final follow-up. VAS, ODI, anterior height of injured vertebral body, and sagittal Cobb angle of affected segment were significantly improved at 3 days after operation and at final follow-up (<0.05). Two patients had complications, including asymptomaticcement leakage in 1 patient and superficial wound infection in 1 patient.
Posterior short-segment pedicle screw internal fixation combined with vertebroplasty for the treatment of Kümmell disease with kyphosis has relatively small surgical trauma, excellent clinical results, good vertebral height recovery, satisfactory correction of kyphotic angle, and fewer complications, etc. It is a safe and effective surgical method to treat Kümmell disease with kyphosis.
探讨后路短节段椎弓根螺钉内固定联合椎体成形术治疗伴有后凸畸形的Kümmell病的临床效果。
回顾性分析2016年1月至2018年12月采用后路短节段椎弓根螺钉内固定联合椎体成形术治疗的24例伴有后凸畸形的Kümmell病患者，其中男性6例，女性18例，年龄63～85岁，平均（73.1±6.5）岁。采用视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）、伤椎前缘高度及术前、术后3天和末次随访时患椎节段矢状面Cobb角评估临床疗效，并观察手术并发症。
24例患者均获随访，随访时间12～24个月，平均（15.5±3.2）个月。VAS评分由术前的5.21±1.06降至术后3天的2.38±0.58及末次随访时的1.71±0.75；ODI由术前的（50.4±13.5）%降至术后3天的（20.9±8.0）%及末次随访时的（16.7±9.6）%；伤椎前缘高度由术前的（8.0±4.2）mm恢复至术后3天的（18.1±5.0）mm及末次随访时的（16.8±5.1）mm；患椎节段矢状面Cobb角由术前的（19.5±6.3）°降至术后3天的（7.6±2.1）°及末次随访时的（8.4±1.7）°。术后3天及末次随访时VAS、ODI、伤椎前缘高度及患椎节段矢状面Cobb角均较术前明显改善（P<0.05）。2例患者出现并发症，其中1例为无症状骨水泥渗漏，1例为浅表伤口感染。
后路短节段椎弓根螺钉内固定联合椎体成形术治疗伴有后凸畸形的Kümmell病手术创伤相对较小，临床效果优良，椎体高度恢复良好，后凸角矫正满意，并发症较少等，是治疗伴有后凸畸形的Kümmell病的一种安全有效的手术方法。
