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经皮椎体后凸成形术治疗腰椎侧弯中的Kümmell病:一例报告

Percutaneous kyphoplasty in the treatment of Kümmell disease in lumbar scoliosis: A case report.

作者信息

Zhou Jia-Wen, Wang Gen-Lin, Sun Ke-Hong, Xie Ji-Le

机构信息

Department of Orthopaedic Surgery, Hangzhou Lin'an Traditional Chinese Medicine Hospital, Affiliated Hospital, Hangzhou City University, Hangzhou 311300, Zhejiang Province, China.

Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China.

出版信息

World J Clin Cases. 2024 Jun 16;12(17):3123-3129. doi: 10.12998/wjcc.v12.i17.3123.

Abstract

BACKGROUND

Due to mechanical imbalance in the spine, elderly scoliosis patients tend to develop vertebral fracture nonunion, , Kümmell disease, when osteoporotic vertebral compression fractures occur. However, accompanying vertebral rotational deformities make surgical procedures challenging risky. Such patients are usually compelled to undergo conservative treatment and there are very few reports on minimally invasive surgeries for them. We first-time report a patient with Kümmell disease and lumbar scoliosis treated with percutaneous kyphoplasty (PKP) under O-arm guidance.

CASE SUMMARY

An 89-year-old female was admitted to the hospital due to delayed low back pain after a fall. She was diagnosed with Kümmell disease based on physical and radiologic examinations. The patient experienced severe scoliosis and subsequently underwent O-arm-guided kyphoplasty, resulting in a significant alleviation of low back pain.

CONCLUSION

PKP has good efficacy in treating Kümmell disease. However, surgical risks are elevated in scoliosis patients with Kümmell disease due to the abnormal anatomical structure of the spine. O-arm assisted operations play a crucial role in decreasing surgical risks.

摘要

背景

由于脊柱的力学失衡,老年脊柱侧弯患者在发生骨质疏松性椎体压缩骨折时,往往会发生椎体骨折不愈合,即 Kümmell 病。然而,伴随的椎体旋转畸形使手术操作具有挑战性且风险较大。这类患者通常被迫接受保守治疗,关于针对他们的微创手术的报道很少。我们首次报告了 1 例在 O 型臂引导下经皮椎体后凸成形术(PKP)治疗 Kümmell 病合并腰椎侧弯的患者。

病例摘要

1 名 89 岁女性因跌倒后出现延迟性腰痛入院。根据体格检查和影像学检查,她被诊断为 Kümmell 病。该患者患有严重脊柱侧弯,随后接受了 O 型臂引导下的椎体后凸成形术,腰痛明显缓解。

结论

PKP 治疗 Kümmell 病疗效良好。然而,由于脊柱解剖结构异常,Kümmell 病合并脊柱侧弯患者的手术风险会升高。O 型臂辅助手术在降低手术风险方面起着关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adab/11185387/d12edc1409a4/WJCC-12-3123-g001.jpg

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