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经皮短节段固定与经皮椎体成形术治疗 Kummell 病的比较:一项至少 2 年随访的回顾性研究。

Comparison between percutaneous short-segment fixation and percutaneous vertebroplasty in treating Kummell's disease: A minimum 2-year follow-up retrospective study.

出版信息

J Back Musculoskelet Rehabil. 2024;37(1):195-203. doi: 10.3233/BMR-230083.

Abstract

BACKGROUND

Percutaneous kyphoplasty (PKP) or percutaneous short-segment fixation (PSSF) is often used to treat Kummell's disease. However, it is not clear which treatment is better for patients.

OBJECTIVE

To retrospectively compare the clinical efficacy of PVP and PSSF for the treatment of Kummell's disease.

METHOD

60 patients were involved in this research and the period of follow-up was at least 2 years. 27 of them were treated with PVP (Group I) and the rest who received PSSF (Group II). The visual analog scale (VAS) and radiographic indexes of each participant had been measured preoperatively as well as 1 week, 3 months, and 2 years postoperatively. Additionally, the Oswestry Disability Index (ODI) scores were assessed at the last time point.

RESULTS

Comparing the two groups, no statistical significance was found among all parameters preoperatively. The time of operations and blood loss is less in Group I. At each time point after operation, the imaging indices in Group II are lower (P< 0.05). One week after treatments, the VAS scores are lower in Group I, and similarly, 3 months are the same (P< 0.05), while VAS are similar at the last time point. In the aspect of ODI scores, they are lower in Group II during long-term follow-up.

CONCLUSION

For the treatment of Kummell's disease, both PVP and PSSF have been found to be effective. PVP can provide rapid pain relief with a shorter operation time. However, in cases with severe kyphosis deformity, PSSF should be given priority.

摘要

背景

经皮椎体后凸成形术(PKP)或经皮短节段固定术(PSSF)常用于治疗 Kummell 病。但哪种治疗方法对患者更好尚不清楚。

目的

回顾性比较 PVP 和 PSSF 治疗 Kummell 病的临床疗效。

方法

本研究共纳入 60 例患者,随访时间至少 2 年。其中 27 例行 PVP(I 组),其余行 PSSF(II 组)。所有患者术前及术后 1 周、3 个月和 2 年均测量视觉模拟评分(VAS)和影像学指标,末次随访时评估 Oswestry 功能障碍指数(ODI)评分。

结果

两组患者术前各参数比较,差异均无统计学意义。I 组手术时间及出血量均较少。术后各时间点,II 组影像学指标均较低(P<0.05)。治疗后 1 周时 I 组 VAS 评分较低,3 个月时差异仍有统计学意义(P<0.05),末次随访时两组 VAS 评分差异无统计学意义。ODI 评分方面,II 组在长期随访中较低。

结论

对于 Kummell 病的治疗,PVP 和 PSSF 均有效。PVP 可迅速缓解疼痛,手术时间较短。但对于严重后凸畸形的患者,应优先选择 PSSF。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aeb8/10789354/a4f9ab1ecfd3/bmr-37-bmr230083-g001.jpg

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