IF 3.4 3区 医学 Q1 ORTHOPEDICS
JOR Spine Pub Date : 2024-12-06 DOI:10.1002/jsp2.70017
Shixiao Zhong, Hui Zhong, Kun Huang, Yayu Zhao, Wen Lei, Weichao Li
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引用次数: 0

摘要

背景:椎体增量术是治疗Kümmell病(KD)的首选方法,但存在骨水泥移位的风险,导致严重背痛和脊柱后凸加重。该研究旨在探讨新型空心椎弓根螺钉联合椎体成形术(HPS-KP)治疗KD的有效性和安全性,有效防止术后骨水泥移位:这项前瞻性研究纳入了50名在临床和放射学评估中未发现神经功能缺损的KD患者,他们分别接受了HPS-KP(25人)和PKP(25人)手术。对两组患者的视觉模拟量表(VAS)评分、Oswestry 功能障碍指数(ODI)、椎体前高度(AVH)、楔形受累椎体 Cobb 角(WCA)、双节段 Cobb 角(BCA)和并发症进行了评估和比较。此外,还构建了 T11-L2 的有限元(FE)模型。对应力分布、椎体和骨水泥的最大 von Mises 应力以及骨水泥的最大位移进行了比较和分析:结果:两组患者术后 3 天、3 个月、6 个月和 1 年的 VAS 和 ODI 评分均明显改善(p p 结论:HPS-KP 是一种安全、有效的治疗方法:HPS-KP是一种安全有效的KD治疗方法,能有效缓解疼痛、恢复椎体高度、矫正局部椎体后凸,在避免骨水泥松动和移位方面,其生物力学稳定性和安全性优于普通单一PKP和PKP联合椎弓根成形术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of Kümmell disease

Clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of Kümmell disease

Background

Vertebral augmentation is the preferred treatment for Kümmell disease (KD), but there exists a risk of cement displacement resulting in severe back pain and exacerbation of kyphosis. The study aimed to investigate the efficacy and safety of a novel hollow pedicle screw combined with kyphoplasty (HPS-KP) for treating KD, effectively preventing postoperative bone cement displacement.

Methods

The prospective study included 50 KD patients with no neurological deficit detected during clinical and radiological evaluation who underwent HPS-KP (n = 25) and PKP (n = 25) surgeries. The visual analogue scale (VAS) score, Oswestry dysfunction index (ODI), anterior vertebral height (AVH), wedge-shape affected vertebral Cobb angle (WCA), bisegmental Cobb angle (BCA), and complications were evaluated and compared in both groups. Besides, a finite element (FE) model of T11-L2 was constructed. The stress distributions, maximum von Mises stresses of vertebrae and bone cement, and maximum displacement of bone cement were compared and analyzed.

Results

The VAS and ODI scores at 3 days, 3 and 6 months, and 1 year after surgery significantly improved in both groups (p < 0.05). The AVH, BCA, and WCA significantly improved initially after the surgery in both groups (p < 0.05). The displacement of M2 was larger than other models, especially in flexion, right bending, and left and right rotation, while that of M6 was the lowest under all conditions.

Conclusion

HPS-KP was a safe and effective treatment for KD, effectively relieving pain, restoring vertebral height, and correcting local kyphosis, and it had better biomechanical stability and safety than ordinary single PKP and PKP combined with pediculoplasty in avoiding cement loosening and displacement.

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来源期刊
JOR Spine
JOR Spine ORTHOPEDICS-
CiteScore
6.40
自引率
18.90%
发文量
42
审稿时长
10 weeks
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