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

### 单侧穿刺经皮椎体后凸成形与椎体成形骨水泥注射治疗Kummell病的对比

1. 湖南省永州市中心医院北院脊柱外科，湖南省永州市  425000
• 收稿日期:2019-03-04
• 作者简介:蒋杰，男，1987年生，湖南省永州市人，汉族，硕士，主治医师，主要从事脊柱外科研究。

### Unipedicular percutaneous vertebroplasty versus percutaneous kyphoplasty bone cement for treating Kummell disease

Jiang Jie, Zhang Yong

1. Department of Spine Surgery, the Central Hospital of Yongzhou, Yongzhou 425000, Hunan Province, China
• Received:2019-03-04
• About author:Jiang Jie, Master, Attending physician, Department of Spine Surgery, the Central Hospital of Yongzhou, Yongzhou 425000, Hunan Province, China

Kummell病：又称椎体内缺血性骨坏死，临床特征为创伤后数周或数月无症状期、迟发性椎体塌陷和受伤椎体出现真空征或裂隙征等，目前多数学者认为该病的病理机制复杂，可能是多种因素如椎体内缺血性坏死、脊柱生物力学改变及骨性结构微骨折损伤修复受阻等相互作用的结果，主流观点认为该病是在骨质疏松性椎体骨折的基础上伤椎椎体局部缺血坏死导致假关节形成，并最终演变为椎体塌陷。

Abstract:

BACKGROUND: Percutaneous vertebroplasty and percutaneous kyphoplasty are effective minimally invasive treatments for type I or II Kummell disease, but it is still unclear which treatment is better.
OBJECTIVE: To compare the clinical efficacy of unipedicular percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of type I or II Kummell disease.
METHODS: Fifty-one patients with Kummell disease were admitted at the Department of Orthopedics, the Central Hospital of Yongzhou from January 2014 to September 2017, including 14 males and 37 females, aged 60-89 years old, responsible for T10-L3. Of which, 27 patients underwent unilateral puncture vertebroplasty with cement injection, and 24 patients underwent unilateral puncture kyphoplasty with cement injection. Intraoperative and postoperative cement leakage, transient fever and re-fracture were recorded. Before treatment, 1 day after treatment and at the last follow-up, the height of the vertebral body of the injured vertebrae and the Cobb angle were evaluated by imaging. Visual Analogue Scale and Oswestry dysfunction index were assessed before treatment and 1 day, 1, 6 and 12 months after treatment. The study was approved by the Ethics Committee of the Central Hospital of Yongzhou, Hunan Province.
RESULTS AND CONCLUSION: (1) There was no significant difference in the occurrence of cement leakage, transient fever and re-fracture between two groups (P > 0.05). (2) The height of the anterior edge of the injured vertebral body and the Cobb angle in the two groups were significantly improved after treatment (P < 0.05), and the improvement in the puncture kyphoplasty group was better than that in the puncture vertebroplasty group (P < 0.05). (3) The Visual Analogue Scale and Oswestry dysfunction index scores after treatment in the two groups were lower than those before treatment (P < 0.05). There was no significant difference in the scores between two groups (P > 0.05). (4) These results show that percutaneous kyphoplasty or percutaneous vertebroplasty can significantly alleviate the pain of patients with Kummell disease and obtain good effectiveness and safety. In contrast, percutaneous kyphoplasty can achieve better imaging height and Cobb angle reduction.

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