球囊后凸成形术:Kummell病的有效治疗方法?

Pius Kim, S. Kim
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引用次数: 19

摘要

目的评价球囊后凸成形术治疗Kummel病合并严重骨质疏松症的疗效。方法选取12例伴有严重骨质疏松症的单级Kummell病患者作为研究对象。体位复位1或2天后,对塌陷的椎体进行球囊后凸成形术。分别于术后7天、1个月和6个月评估临床结果、影像学参数和相关并发症。结果后凸成形术前,平均疼痛评分(按视觉模拟评分)为8.0。手术后7天,该分数提高到2.5分。尽管与术前相比有显著改善,但在手术后6个月评分上升至4.0。平均术前椎体高度损失为55.4%。后凸成形术将这一损失减少到31.6%,但在手术后6个月增加到38.7%。后凸角从术前的22.4°±4.9°明显改善到术后的10.1°±3.8°,但术后6个月后未保持改善的角度。术后6个月后凸畸形的平均矫正损失为7.2°。12例患者中有3例术后6个月内发生相邻骨折。结论虽然已知球囊后凸成形术治疗Kummell病可提供稳定和疼痛缓解,但它可能与邻近骨折的发展和后凸加重有关。
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Balloon Kyphoplasty: An Effective Treatment for Kummell Disease?
Objective The purpose of this study was to evaluate the efficacy of balloon kyphoplasty for treating Kummel disease accompanying severe osteoporosis. Methods Twelve patients with single-level Kummell disease accompanied by severe osteoporosis were enrolled in this investigation. After postural reduction for 1 or 2 days, balloon kyphoplasty was performed on the collapsed vertebrae. Clinical results, radiological parameters, and related complications were assessed at 7 days, 1 month and 6 months after the procedure. Results Prior to kyphoplasty, the mean pain score (according to the visual analogue scale) was 8.0. Seven days after the procedure, this score improved to 2.5. Despite the significant improvement compared to preoperative value, the score increased to 4.0 at 6 months after the procedure. The mean preoperative vertebral height loss was 55.4%. Kyphoplasty reduced this loss to 31.6%, but it increased to 38.7% at 6 months after the procedure. The kyphotic angle improved significantly from 22.4°±4.9° (before the procedure) to 10.1°±3.8° after surgery, However, the improved angle was not maintained 6 months after the procedure. The mean correction loss for the kyphotic deformity was 7.2° at 6 months after the procedure. Three out of 12 patients sustained adjacent fractures after balloon kyphoplasty within 6 months. Conclusion Although balloon kyphoplasty for treating Kummell disease is known to provide stabilization and pain relief, it may be associated with the development of adjacent fractures and aggravated kyphosis.
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