中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (8): 1069-1074.doi: 10.3969/j.Issn.2095-4344.2016.08.001

• 组织工程骨及软骨材料 tissue-engineered bone and cartilage materials •    下一篇

高黏度骨水泥椎体成形治疗Kümmell病

张 亮,冯新民,王静成,陶玉平,杨建东,张圣飞,黄吉军,蔡 俊,张志强   

  1. 江苏省苏北人民医院,江苏省扬州市 225001
  • 收稿日期:2015-12-02 出版日期:2016-02-19 发布日期:2016-02-19
  • 通讯作者: 冯新民,主任医师,教授,硕士生导师,苏北人民医院,江苏省扬州市 225001
  • 作者简介:张亮,男,1983年生,江苏省泰州市人,2012年解放军第二军医大学毕业,博士后,博士,副主任医师,讲师,主要从事脊柱外科方面的研究。
  • 基金资助:
    国家自然科学基金(青年基金81401830);江苏省自然科学基金(青年基金BK 20140496)

Percutaneous vertebroplasty with high-viscosity bone cement treats Kümmell disease

Zhang Liang, Feng Xin-min, Wang Jing-cheng, Tao Yu-ping, Yang Jian-dong, Zhang Sheng-fei, Huang Ji-jun, Cai Jun, Zhang Zhi-qiang   

  1. Northern Jiangsu People’s Hospital, Yangzhou 225001, Jiangsu Province, China
  • Received:2015-12-02 Online:2016-02-19 Published:2016-02-19
  • Contact: Feng Xin-min, Chief physician, Professor, Master’s supervisor, Northern Jiangsu People’s Hospital, Yangzhou 225001, Jiangsu Province, China
  • About author:Zhang Liang, M.D., Associate chief physician, Lecturer, Northern Jiangsu People’s Hospital, Yangzhou 225001, Jiangsu Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81401830; the Natural Science Foundation of Jiangsu Province of China, No. BK20140496

摘要:

文章快速阅读:

 

文题释义:
Kümmell病:其特征主要为轻微脊柱外伤患者经几周至几个月的无症状期后,逐渐发展为持续性的胸背部疼痛、椎体塌陷及进展性的脊柱后凸畸形。目前大多数学者对此类疾病的定义为由于椎体骨折处缺血坏死不愈合,导致创伤后迟发性椎体塌陷。

经皮椎体成形:是指经皮通过椎弓根或椎弓根外向椎体内注入骨水泥以达到增加椎体强度和稳定性,防止塌陷,缓解疼痛,甚至部分恢复椎体高度为目的一种微创脊椎外科技术。

 

背景:由于经皮椎体成形治疗具有创伤小、疼痛缓解迅速等优点,逐渐被用于治疗Kümmell病,但仍存在较高的骨水泥渗漏率。
目的:探讨高黏度骨水泥椎体成形结合过伸体位复位治疗Kümmell病的效果。
方法:回顾性分析17例Kümmell 病患者的临床资料,其中男5例,女12例,年龄55-83岁,均进行高黏度骨水泥椎体成形过结合过伸体位复位治疗。检测治疗前后的目测类比评分、Oswestry功能障碍指数评分、伤椎椎体高度及伤椎后凸畸形角度,同时记录骨水泥渗漏、肺栓塞、邻近椎体骨折等并发症发生情况。
结果与结论:治疗后随访12个月时,患者的目测类比评分、Oswestry功能障碍指数评分、伤椎后凸畸形角度均显著低于治疗前(P < 0.05),伤椎椎体高度显著高于治疗前(P < 0.05)。治疗后,发生骨水泥渗漏3例,均无特殊不适及神经症状;新发骨折1例。表明采用过伸体位复位结合高黏度骨水泥椎体成形治疗Kümmell病,可有效缓解腰背痛,改善腰背部功能,部分恢复椎体高度,减小后凸畸形角度。 

 ORCID: 0000-0001-7561-1488(张亮)

关键词: 生物材料, 骨生物材料, 骨水泥, 黏度, 椎体成形, Kümmell 病, 过伸体位, 国家自然科学基金

Abstract:

BACKGROUND: Percutaneous vertebroplasty has been gradually used to treat Kümmell disease because of less trauma and quick pain relief, but there is still a high rate of bone cement leakage.
OBJECTIVE: To investigate the clinical efficacy of percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset for treatment of Kümmell’s disease.
METHODS: The clinical data of 17 patients with Kümmell’s disease were retrospectively analyzed, including 5 males and 12 females, aged 55-83 years, and all underwent percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset. The visual analog scale, Oswestry disability index score, vertebral body height and vertebral kyphosis angle were determined. The bone cement leakage, pulmonary embolism, adjacent vertebral fractures and other complications were recorded.
RESULTS AND CONCLUSION: At the 12th month of follow-up, the visual analog scale scores, Oswestry disability index scores and vertebral kyphosis angle of patients were significantly lower than those before treatment  (P < 0.05), the vertebral body height was significantly higher than that before treatment (P < 0.05). After treatment, there were three cases of bone cement leakage, which had no special discomfort and neurological symptoms, and one case of new fractures. These results demonstrate that hyperextension position reset combined with percutaneous vertebroplasty with high-viscosity bone cement in treatment of Kümmell’s disease can effectively relieve back pain, improve function of the lower back, partially restore vertebral height and reduce kyphosis angle.