Liu Yapu, Su Yuanyuan, Luan Zhonghao, Hou Xiuwei, Wu Guangliang, Xu Yonghui, Wang Songmao, Gao Lifeng, Zheng Xiaochen
Department of Spinal Surgery, Second Affiliated Hospital of Luohe Medical College, Luohe, People's Republic of China.
J Pain Res. 2024 Aug 26;17:2767-2774. doi: 10.2147/JPR.S469755. eCollection 2024.
To introduce the surgical methods and clinical results of percutaneous vertebroplasty (PVP) combined with hollow screw placement as a treatment for patients with Kummell's disease and pedicle rupture.
From January 2020 to January 2023, a total of 10 patients with Kummell's disease and pedicle rupture confirmed via imaging underwent three-column intensive therapy using hollow screws combined with PVP. There were two males and eight females with an average age 75.7±6.11 years old. The time of operation, bone cement injection amount, bone cement leakage during operation were recorded. X-ray and CT were reexamined after operation. The improvement in quality of life was assessed using the Oswestry Disability Index (ODI), and the improvement in low back pain was assessed using the visual analogue scale (VAS).
Hollow screw placement combined with PVP was successfully performed in all patients. The average operation time was 39.2±5.1 min, and the average volume of bone cement injected was 5.85±0.83mL. No leakage of bone cement into spinal canal occurred.The mean preoperative ODI score was 75.70±4.39, but this decreased significantly postoperatively(P<0.05), being 37.70±6.95 at 1 day and 26.40±4.90, 23.70±4.87, 21.70±5.46, and 20.50±4.21 at 1, 3, 6, and 12 months after the operation, respectively. The mean VAS pain score before the operation was 8.35±0.63, but the symptoms of back pain were significantly relieved after operation(P<0.05). The mean VAS scores 1 day and 1, 3, 6, and 12 months after the operation were 3.45±0.47, 2.55±0.60, 1.89±0.48, 1.50±0.27, and 1.12±0.20, respectively.
Hollow screw placement combined with percutaneous vertebroplasty serves as a valuable three-column intensive treatment for patients with Kummell's disease and pedicle rupture. This procedure has the advantages of minimal trauma, less pain and quick recovery. The strong anchoring of bone cement and hollow screws provides stable and firm healing conditions for vertebral and pedicle fractures.
介绍经皮椎体成形术（PVP）联合空心螺钉置入治疗Kummell病合并椎弓根破裂患者的手术方法及临床效果。
2020年1月至2023年1月，共有10例经影像学确诊为Kummell病合并椎弓根破裂的患者接受了空心螺钉联合PVP的三柱强化治疗。其中男性2例，女性8例，平均年龄75.7±6.11岁。记录手术时间、骨水泥注入量、术中骨水泥渗漏情况。术后复查X线和CT。采用Oswestry功能障碍指数（ODI）评估生活质量改善情况，采用视觉模拟评分法（VAS）评估腰痛改善情况。
所有患者均成功实施了空心螺钉置入联合PVP。平均手术时间为39.2±5.1分钟，平均骨水泥注入量为5.85±0.83mL。无骨水泥渗漏至椎管内。术前ODI平均评分为75.70±4.39，但术后显著降低（P<0.05），术后1天为37.70±6.95，术后1、3、6和12个月分别为26.40±4.90、23.70±4.87、21.70±5.46和20.50±4.21。术前VAS疼痛平均评分为8.35±0.63，但术后背痛症状显著缓解（P<0.05）。术后1天及1、3、6和12个月的VAS平均评分分别为3.45±0.47、2.55±0.60、1.89±0.48、1.50±0.27和1.12±0.20。
空心螺钉置入联合经皮椎体成形术是治疗Kummell病合并椎弓根破裂患者的一种有价值的三柱强化治疗方法。该手术具有创伤小、疼痛轻、恢复快等优点。骨水泥和空心螺钉的强力锚固为椎体和椎弓根骨折提供了稳定而牢固的愈合条件。
