Percutaneous kyphoplasty for stage III Kümmell＇s disease with no neurological symptom

Q4 Medicine

中华创伤骨科杂志 Pub Date : 2019-10-15 DOI:10.3760/CMA.J.ISSN.1671-7600.2019.10.012

Yijie Liu, Sen Yang, Xuefeng Li, Weimin Jiang, Renjie Li, Heng Wang, Huaqing Guan, Jie Chen, Genlin Wang

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Abstract

Objective To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) in the treatment of stage Ⅲ Kummell＇s disease with no neurological symptom. Methods From January 2009 to June 2018, 45 patients underwent PKP for stage Ⅲ Kummell＇s disease with no neurological symptom at Department of Orthopaedics, The First Hospital Affiliated to Soochow University. They were 12 males and 33 females, aged from 61 to 85 years (average, 70.9 years). Their visual analog scale (VAS) scores for back pain, Oswestry disability indexes (ODI), heights of fractured vertebrae and kyphosis cob angles were recorded and compared between preoperation, one day, 3 months and final follow-up after operation. Results All the 45 patients were followed up for 12 to 48 months (average, 28.0 months). Their VAS scores (2.4±0.7, 2.2±0.7 and 2.3±0.6), ODI sores (34.7±6.8, 34.2±6.5 and 34.1±6.6) and cobb angles (15.7°±2.2°, 15.8°±2.2° and 15.9°±2.4°) at one day, 3 months and final follow-up after operation were significantly lower than those (8.2±1.1, 75.3±9.0 and 25.2°±3.9°) before operation (P<0.001). Their anterior height ratios of the fractured vertebra (54.0%±4.3%, 53.7%±4.2% and 53.6%±4.0%) and median height ratios of the fractured vertebra (56.8%±4.0%, 56.5%±3.9% and 56.6%±3.9%) at one day, 3 months and final follow-up after operation were significantly higher than those (25.8%±3.9% and 27.2%±3.1%) before operation (P<0.001). The rate of cement leakage was 13.3%(6/45). No patients had neurological symptoms after operation. Conclusion PKP is a minimally invasive, safe and effective treatment for stage Ⅲ Kummell's disease with no neurological symptom, because it can relieve the symptoms of the patients, restore the height of the fractured vertebral body and reduce the local kyphosis cobb angle. Key words: Vertebroplasty; Kyphosis; Spinal cord compression; Kummell’s disease

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经皮后凸成形术治疗无神经系统症状的III期Kümmell病

目的评价经皮后凸成形术（PKP）治疗无神经系统症状的Ⅲ期Kummell病的临床疗效。方法自2009年1月至2018年6月，在苏州大学附属第一医院骨科对45例无神经系统症状的Ⅲ期Kummell病患者进行PKP治疗。他们是12名男性和33名女性，年龄从61岁到85岁（平均70.9岁）。记录他们的背痛视觉模拟量表（VAS）评分、奥斯韦斯特里残疾指数（ODI）、骨折椎骨高度和后凸颈角，并在术前、术后1天、术后3个月和术后最后一次随访期间进行比较。结果45例患者随访12～48个月，平均28.0个月。一天VAS评分（2.4±0.7、2.2±0.7和2.3±0.6）、ODI溃疡（34.7±6.8、34.2±6.5和34.1±6.6）和cobb角（15.7°±2.2°、15.8°±220°和15.9°±2.4°），术后3个月和最后一次随访的骨折椎体前高比（54.0%±4.3%、53.7%±4.2%和53.6%±4.0%）和中高比（56.8%±4.0%、56.5%±3.9%和56.6%±3.9%）均显著低于术前（8.2±1.1、75.3±9.0和25.2°±3.9°）（P＜0.001），术后3个月及最终随访时间均显著高于术前（25.8%±3.9%和27.2%±3.1%）（P＜0.001），水泥渗漏率为13.3%（6/45），术后无神经系统症状。结论PKP是一种微创、安全、有效的治疗Ⅲ期Kummell病的方法，无神经系统症状，能减轻患者的症状，恢复骨折椎体的高度，减少局部后凸角。关键词：脊椎成形术；Kyphosis；脊髓压迫；库马尔病

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