CAJ | 학술논문

目的观察经皮椎体成形术(PVP)和椎体后凸成形术(PKP)治疗骨质疏松性椎体Kummell'8病的效果.方法采用经皮PVP和PKP治疗骨质疏松性Kummell's病63例65个椎体,分为经皮PVP组35例次,PKP组30个节段.分别于手术前1d,手术后1d、1周、4周、12周、24周和术后1年测定疼痛视觉模拟评分；测定后凸矫正比率,观察骨水泥渗漏率.结果 VAS评分:手术前PVP组和PKP组分别为(9.6±0.3)分和(9.8±0.2)分,2组间差异无统计学意义(P＞0.05),手术后1年分别为(2.3±1.2)分和(2.5±1.1)分,2组疼痛视觉模拟评分评分均较手术前明显下降(P＜0.01),至末次随访,两组间VAS评分差异无统计学意义(P＞0.05).后凸畸形矫正率,PVP组和PKP组分别为(45.50±3.15)％和(47.83±4.24)％(P＞0.05).骨水泥渗漏率PVP组5例14.29％,PKP组4例渗漏(13.33％),两者差异无统计学意义(P＞0.05).结论 Kummell'8病是一种特殊类型的骨折,PVP和PKP技术治疗均可获得明显的止疼效果.并可获得部分的后凸矫正效果；由于病变椎体内由裂隙、上下的硬化面和前方的前纵韧带形成了一个封闭的空间,骨水泥异常渗漏发生率较低.
목적 관찰경피추체성형술(PVP)화추체후철성형술(PKP)치료골질소송성추체Kummell'8병적효과.방법 채용경피PVP화PKP치료골질소송성Kummell's병63례65개추체,분위경피PVP조35례차,PKP조30개절단.분별우수술전1d,수술후1d、1주、4주、12주、24주화술후1년측정동통시각모의평분；측정후철교정비솔,관찰골수니삼루솔.결과 VAS평분:수술전PVP조화PKP조분별위(9.6±0.3)분화(9.8±0.2)분,2조간차이무통계학의의(P＞0.05),수술후1년분별위(2.3±1.2)분화(2.5±1.1)분,2조동통시각모의평분평분균교수술전명현하강(P＜0.01),지말차수방,량조간VAS평분차이무통계학의의(P＞0.05).후철기형교정솔,PVP조화PKP조분별위(45.50±3.15)％화(47.83±4.24)％(P＞0.05).골수니삼루솔PVP조5례14.29％,PKP조4례삼루(13.33％),량자차이무통계학의의(P＞0.05).결론 Kummell'8병시일충특수류형적골절,PVP화PKP기술치료균가획득명현적지동효과.병가획득부분적후철교정효과；유우병변추체내유렬극、상하적경화면화전방적전종인대형성료일개봉폐적공간,골수니이상삼루발생솔교저.
Objective To evaluate the results of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) for the treatment of osteoporotic vertebral Kummell' s disease.Methods 63 patients suffered 65 vertebral Kummell' s dieasess were treated with PVP or PKP.PVP group:33 patients,35 verthereas,3 men and 29 women aged 46-81 years [ mean,(69.2 ±6.3) years] ; PKP group:30 patients,30 verthebreas 3 men and 27 women aged 52-79 years [ mean,(68.7 ± 6.5 ) years ].Results Postoprative VAS scales ( 1 day,1 week,4 weeks,8 weeks,24 weeks,1 year) of all patients reduced obviously with a significant difference ( P ＜0.01 ),the changes of VAS had no significant difference between two groups ( P ＞ 0.05 ).The restorations of kyphosis were observed in both groups,but no significant difference between two groups ( P ＞ 0.05 ).All patients were satisfied with these treatments,but no significant difference between two groups (P ＞ 0.05).The rates of cement leakage had no significant difference beteen the PVP group and the PKP group ( P ＞ 0.05 ).Conclusion Both percutaneous vertebroplasty and kyphoplasty can effectively relieve the back pain.PVP is the first selecetion for the treatment of Kummell' s dieasess.