CAJ | 학술논문

椎体后凸成形术治疗无神经症状Kümmell病的疗效观察
추체후철성형술치료무신경증상Kümmell병적료효관찰
Kyphoplasty for Kümmell disease without neurological deficit

万方数据

中国骨与关节外科中國骨與關節外科 중국골여관절외과
CHINESE BONE AND JOINT SURGERY
2013年 6期 477-481 ,共5页

柳扬%包呼日查%孙永青%范磊%郝敬东%崔准%张怀华%康建国%任磊%邓超%赵大中%蒋育欣

류양%포호일사%손영청%범뢰%학경동%최준%장부화%강건국%임뢰%산초%조대중%장육흔

Kümmell病%椎体后凸成术 Kümmell病%椎體後凸成術
Kümmell병%추체후철성술
Kümmell disease%Kyphoplasty

背景：目前，Kümmell病相关文献报道较少，诊断和治疗仍存争议，对于此病的认识有待进一步加深。 　　目的：深化对Kümmell病的认识并探讨椎体后凸成形术治疗无神经症状Kümmell病的短期疗效。 　　方法：2007年2月至2012年3月，13例无神经症状Kümmell病患者接受球囊扩张椎体后凸成形术。分别于术前、术后记录Oswestry功能障碍指数（ODI）、疼痛视觉模拟评分（VAS）、伤椎和邻椎高度、受累节段矢状面Cobb角，认为VAS减少50%为疼痛明显缓解，ODI减少50%为功能明显改善。 　　结果：患者术后3 d，1个月、3个月、12个月VAS平均评分分别为6.7±0.88、4.3±0.64、3.6±0.69和3.2±0.90，与术前比较均有显著统计学差异（P<0.05），末次随访时疼痛缓解率为81%。12例患者的运动功能有明显改善；术后3 d，1个月、3个月、12个月ODI平均评分分别为23.5±1.90、15.0±0.86、13.8±0.60和12.5±0.50，与术前比较均有显著统计学差异（P<0.05），末次随访时运动功能改善率为71%。术后伤椎高度较术前明显增加，术后12个月时伤椎高度平均为（18.5±1.59）cm，与术前比较有显著统计学差异（P<0.05）。但术后随访时各时间点邻椎高度较术前无明显改变（P>0.05）。术后伤椎节段Cobb角较术前明显减小，术后12个月时伤椎节段Cobb角平均为14.6°±1.46°，与术前比较有显著统计学差异（P<0.05）。 　　结论：目前对于Kümmell病的认识仍存不全面；椎体后凸成形术是治疗无神经症状Kümmell病有效方法之一。
배경：목전，Kümmell병상관문헌보도교소，진단화치료잉존쟁의，대우차병적인식유대진일보가심。 　　목적：심화대Kümmell병적인식병탐토추체후철성형술치료무신경증상Kümmell병적단기료효。 　　방법：2007년2월지2012년3월，13례무신경증상Kümmell병환자접수구낭확장추체후철성형술。분별우술전、술후기록Oswestry공능장애지수（ODI）、동통시각모의평분（VAS）、상추화린추고도、수루절단시상면Cobb각，인위VAS감소50%위동통명현완해，ODI감소50%위공능명현개선。 　　결과：환자술후3 d，1개월、3개월、12개월VAS평균평분분별위6.7±0.88、4.3±0.64、3.6±0.69화3.2±0.90，여술전비교균유현저통계학차이（P<0.05），말차수방시동통완해솔위81%。12례환자적운동공능유명현개선；술후3 d，1개월、3개월、12개월ODI평균평분분별위23.5±1.90、15.0±0.86、13.8±0.60화12.5±0.50，여술전비교균유현저통계학차이（P<0.05），말차수방시운동공능개선솔위71%。술후상추고도교술전명현증가，술후12개월시상추고도평균위（18.5±1.59）cm，여술전비교유현저통계학차이（P<0.05）。단술후수방시각시간점린추고도교술전무명현개변（P>0.05）。술후상추절단Cobb각교술전명현감소，술후12개월시상추절단Cobb각평균위14.6°±1.46°，여술전비교유현저통계학차이（P<0.05）。 　　결론：목전대우Kümmell병적인식잉존불전면；추체후철성형술시치료무신경증상Kümmell병유효방법지일。
Background:There are few studies reported on Kummell's disease. Therefore, it remains incomplete. Objective:To evaluate the efficacy of kyphoplasty for Kümmell disease in patients without neurological deficit. Methods:Thirteen patients with Kümmell disease without neurological deficit were treated with kyphoplasty from February 2007 to March 2012. The visual analogue scale (VAS), Oswestry disability index (ODI), and the height and kyphotic angle of involved vertebral body were measured to evaluate clinical outcomes before and after surgery. The successful treatment was defined as VAS or ODI reduction at least 50%. Results:VAS scores were 6.7±0.88, 4.3±0.64, 3.6±0.69 and 3.2±0.90 at 3 d, 1 month, 3 months and 12 months postopera-tively, which were significantly lower than the preoperative one (7.9 ± 0.70, P<0.05). The rate of pain relief was 81%. ODI were 23.5±1.90, 15.0±0.86, 13.8±0.60 and 12.5±0.50 at 3 d, 1 month, 3 months and 12 months postoperatively, which were significantly lower than the preoperative one (30.8±4.60, P<0.05). The function improving rate was 71%at the final follow-up. The motor function was improved significantly after surgery in 12 patients. The mean injured vertebral height increased from (13.8 ± 1.36) cm preoperatively to (18.5 ± 1.59) cm 12 months postoperatively (P<0.05). The mean Cobb angle of in-volved vertebrae reduced significantly from 20.8°±2.46° preoperatively to 14.6°±1.46° 12 months postoperatively (P<0.05). There was no significant difference in adjacent vertebral height before and after surgery. Conclusions:The current understanding of Kummell's disease is still limited. Kyphoplasty is effective for Kümmell disease in the patients without neurological deficit.