Kan Dongjie, Wang Jinghuai, Qiao Guoyong, Chen Yanan, Han Dongping
Department of Orthopedic, Affiliated Hospital of Hebei University of Engineering, Handan City, Hebei Province, 056000, China.
Jt Dis Relat Surg. 2025 Jan 2;36(1):15-23. doi: 10.52312/jdrs.2024.1834. Epub 2024 Nov 22.
The study aimed to evaluate the efficacy and safety of hollow pedicle screw-anchored bone cement combined with posterior long-segment fixation (LSF) for the treatment of Stage III Kümmell's disease.
The study retrospectively analyzed 23 patients (18 females, 5 males; mean age: 70.1±6.2 years; range, 58 to 80 years) with Stage III Kümmell's disease who underwent hollow pedicle screw-anchored bone cement combined with posterior LSF between March 2017 and April 2020. The clinical efficacy was evaluated using the Visual Analog scale (VAS), the Oswestry Disability Index (ODI), anterior vertebral height, kyphotic Cobb angle, and neurological function by Frankel classification. Complications, operation time, intraoperative blood loss, and complications were obtained from the hospital records. Data recorded at three time intervals (before the surgery, early postoperative period, and the last follow-up) were compared.
The mean follow-up time was 20.8±6.1 months. The mean operation time was 102±16.5 min, and the mean intraoperative blood loss was 225±41.3 mL. The VAS, ODI, anterior vertebral heights, and local kyphosis angle showed statistically significant differences between preoperative and postoperative values, as well as the preoperative and the final follow-up values (p<0.05). However, the differences between postoperative and final follow-up values were not statistically significant (p>0.05). Six patients (26%) had mild preoperative neurological deficits and normalized neurological function at the final follow-up evaluation. Asymptomatic leakage of cement occurred in five (22%) cases. There was no fixation failure (rod breakage or screw loosening).
Hollow pedicle screw-anchored bone cement combined with posterior LSF is a safe and effective surgical option for the treatment of Stage III Kümmell's disease.
本研究旨在评估空心椎弓根螺钉锚定骨水泥联合后路长节段固定（LSF）治疗Ⅲ期Kümmell病的疗效和安全性。
本研究回顾性分析了2017年3月至2020年4月期间接受空心椎弓根螺钉锚定骨水泥联合后路LSF治疗的23例Ⅲ期Kümmell病患者（18例女性，5例男性；平均年龄：70.1±6.2岁；范围58至80岁）。采用视觉模拟量表（VAS）、Oswestry功能障碍指数（ODI）、椎体前缘高度、后凸Cobb角以及Frankel分级评估神经功能来评价临床疗效。并发症、手术时间、术中出血量等数据来自医院记录。对三个时间点（术前、术后早期和末次随访）记录的数据进行比较。
平均随访时间为20.8±6.1个月。平均手术时间为102±16.5分钟，平均术中出血量为225±41.3毫升。VAS、ODI、椎体前缘高度和局部后凸角在术前与术后以及术前与末次随访时均有统计学显著差异（p<0.05）。然而，术后与末次随访时的差异无统计学意义（p>0.05）。6例患者（26%）术前有轻度神经功能缺损，在末次随访评估时神经功能恢复正常。5例（22%）发生了无症状骨水泥渗漏。无内固定失败（棒断裂或螺钉松动）情况。
空心椎弓根螺钉锚定骨水泥联合后路LSF是治疗Ⅲ期Kümmell病的一种安全有效的手术选择。
