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对比分析经皮椎体成形术和球囊扩张椎体后凸成形术治疗无神经症状 III 期 Kummell 病的疗效:一项回顾性研究。

Comparative analysis of percutaneous vertebroplasty and kyphoplasty in the treatment of Stage III Kummell's disease without neurological symptoms: a retrospective study.

机构信息

Department of Spine Surgery, First Clinical Medical College of Three Gorges University, Yichang, 443003, Hubei, China.

Department of Public Health, College of Medicine and Health Sciences, China Three Gorges University, Yichang, China.

出版信息

J Orthop Surg Res. 2024 Aug 27;19(1):515. doi: 10.1186/s13018-024-05019-w.

Abstract

OBJECTIVE

This study analyzes the safety and efficacy of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) treatments for Stage III Kummell's disease without neurological symptoms, comparing the advantages and disadvantages of these two minimally invasive surgical methods.

METHODS

A retrospective analysis was conducted on 53 patients with non-neurological Stage III Kummell's disease treated with PVP and PKP at our hospital from December 2018 to January 2023. Patients were divided into PVP (25 cases) and PKP (28 cases) groups based on the surgical method. There were no significant differences in general preoperative data between the two groups (all p > 0.05), ensuring comparability. The study compared surgical duration, volume of bone cement injected, distribution pattern of bone cement, rate of bone cement leakage, and preoperative, postoperative, and final follow-up scores of Visual analogue scale(VAS) and Oswestry disability index(ODI). Additionally, relative anterior height of the injured vertebrae, and Cobb angle of deformity, along with their changes at preoperative, postoperative, and final follow-up stages were calculated and analyzed.

RESULTS

No significant preoperative differences were observed between the groups (p > 0.05). The PKP group had longer surgeries, higher cement volumes (p < 0.001), and lower leakage rates (p < 0.05), with primarily chunky cement distributions versus mixed distributions in the PVP group. No complications other than cement leakage occurred. VAS and ODI scores showed no significant changes at various time points (p > 0.05) but improved significantly from preoperative (p < 0.001). Both groups saw improved vertebral heights and Cobb angles post-surgery (p < 0.05), with more significant improvements in the PKP group (p < 0.05). Over time, both groups experienced gradual vertebral height loss and increased Cobb angles, more pronounced in the PKP group (p < 0.05). At the final follow-up, there were no statistical differences in vertebral height and Cobb angle between the two groups (p > 0.05).

CONCLUSION

The study evaluates the safety and efficacy of PVP and PKP for Stage III Kummell's disease without neurological symptoms, comparing the merits of both minimally invasive techniques.

摘要

目的

本研究分析了经皮椎体后凸成形术(PVP)和经皮椎体成形术(PKP)治疗无神经症状的 III 期 Kummell 病的安全性和有效性,比较了这两种微创手术方法的优缺点。

方法

回顾性分析了 2018 年 12 月至 2023 年 1 月我院收治的 53 例非神经 III 期 Kummell 病患者,根据手术方法分为 PVP(25 例)和 PKP(28 例)组。两组一般术前资料无显著性差异(均 p>0.05),具有可比性。研究比较了手术时间、骨水泥注射量、骨水泥分布模式、骨水泥渗漏率,以及术前、术后和最终随访时视觉模拟评分(VAS)和 Oswestry 功能障碍指数(ODI)的评分。此外,计算并分析了伤椎相对前高和畸形 Cobb 角及其在术前、术后和最终随访阶段的变化。

结果

两组患者术前无显著性差异(p>0.05)。PKP 组手术时间较长,骨水泥用量较高(p<0.001),渗漏率较低(p<0.05),主要为块状骨水泥分布,而 PVP 组为混合分布。除骨水泥渗漏外,无其他并发症发生。VAS 和 ODI 评分在各时间点均无明显变化(p>0.05),但与术前相比均有显著改善(p<0.001)。两组术后椎体高度和 Cobb 角均有改善(p<0.05),PKP 组改善更明显(p<0.05)。随着时间的推移,两组均出现椎体高度逐渐丢失和 Cobb 角增加,PKP 组更为明显(p<0.05)。最终随访时,两组椎体高度和 Cobb 角无统计学差异(p>0.05)。

结论

本研究评估了 PVP 和 PKP 治疗无神经症状的 III 期 Kummell 病的安全性和有效性,比较了这两种微创技术的优缺点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d96/11348757/612b0cf4f667/13018_2024_5019_Fig1_HTML.jpg

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