[1]吴瑞 王博 周纪平 杨永军 姚树强 杨凯.有限截骨矫形手术治疗3期骨质疏松性椎体骨折骨不连[J].中国中医骨伤科杂志,2021,29(03):75-78.
　WU Rui WANG Bo ZHOU Jiping YANG Yongjun YAO Shuqiang YANG Kai.Clinical Efficacy of Limited Osteotomy Surgery for Treatment of Stage 3 Kummell’s Disease[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(03):75-78.
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有限截骨矫形手术治疗3期骨质疏松性椎体骨折骨不连()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年03期
页码:
75-78
栏目:
临床报道
出版日期:
2021-03-15

文章信息/Info

Title:
Clinical Efficacy of Limited Osteotomy Surgery for Treatment of Stage 3 Kummell’s Disease
文章编号:
1005-0205(2021)03-0075-04
作者:
吴瑞 王博 周纪平 杨永军 姚树强 杨凯
1山东省文登整骨医院(山东 威海,264400)△通信作者 E-mail:abcdzhoujiping@163.com
Author(s):
WU Rui WANG Bo ZHOU Jiping YANG Yongjun YAO Shuqiang YANG Kai
1Department of Osteopathics,Shandong Wendeng Hospital,Wendeng 264400,Shandong China.
关键词:
骨质疏松性椎体骨折骨不连;  截骨;  内固定
Keywords:
Kummell’s disease;  osteotomy;  internal fixation
分类号:
R683.2
文献标志码:
B
摘要:
目的:探讨运用有限截骨矫形手术治疗3期骨质疏松性椎体骨折骨不连的临床疗效。方法:选取2015年至2019年本科收治的30名3期骨质疏松性椎体骨折骨不连患者,运用有限截骨矫形手术进行治疗,统计其手术时间、出血量,对术前、术后及随访VAS评分、ODI评分、Cobb角数据进行比较。结果:平均手术时间为(2.65±0.39)h,平均出血量为(313.33±73.03)mL,术前Cobb角42.43°±6.66°,术后1 a Cobb角7.43°±2.25°,术前VAS评分为(6.87±1.59)分,随访VAS评分为(1.03±0.41)分,术前ODI评分为(0.718±0.113)分,随访ODI评分为(0.119±0.047)分,差异均有统计学意义(P<0.05)。术后随访植骨牢固愈合,无内固定松动断裂等情况发生。结论:有限截骨矫形手术在治疗3期骨质疏松性椎体骨折骨不连时具有良好的临床疗效,减压充分,矫形良好,融合率高,具有较好的推广价值。
Abstract:
To investigate the clinical efficacy of limited osteotomy for the treatment of Kummell’s disease at stage 3.Methods:30 patients with stage 3 Kummell’s disease from 2015 to 2019 were selected and treated with limited osteotomy surgery.The operation time and blood loss were counted.The data of preoperative,postoperative,follow-up VAS score,ODI score and cobb angle were compared.Results:The mean operative time was(2.65±0.39)hours.The mean blood loss was(313.33±73.03)mL.The preoperative Cobb Angle was 42.43°±6.66°,and the Cobb Angle was 7.43°±2.25° 1 year after the operation.The preoperative VAS score was 6.87±1.59.The follow-up VAS score was 1.03±0.41.The preoperative ODI score was 0.718±0.113,and the follow-up ODI score was 0.119±0.047.All the differences were statistically significant(P< 0.05).After the follow-up,the bone graft healed firmly,and there was no loosening or fracture of internal fixation.Conclusion:Limited osteotomy and orthopedic surgery in treating stage 3 Kummell’s disease has good clinical efficacy with full decompression,good orthopedic,high fusion rate and has good promotion value.

参考文献/References:

[1] KUMMELL H. Die rarefizierende ostitis der wirbelkorper[J]. DeutscheMed,1895,21(1):180-181.
[2] 戴力扬.Kummell病[J].中国脊柱脊髓杂志,1999,9(6):347-354.
[3] 滕彬彬,吴小丽,游斌.Kummell 病的 MRI 表现分析[J].中国中西医结合影像学杂志,2018,7(16):414-416.
[4] LEE C S,YU J W,CHUNG S S,et al.Delayed post-traumatic vertebral collapse:MR categorization and MR-pathology correlation[J].Asian Spine J,2007,1(1):32-37.
[5] PAPPOU I P,PAPADOPOULOS E C,SWANSON A N,et al.Osteoporotic vertebral fractures and collapse with intravertebral vacuum sign(Kummell’s Disease)[J].Orthopedics,2008,31(1):61-66
[6] LI K C,WONG T U,KUNG F C,et al. Staging of Kümmell’s disease[J]. J Muscul Res,2004,8(2):43.
[7] WU A M,CHI Y L,NI W F.Vertebral compression fracture with intravertebral vacuum cleft sign:pathogenesis,image,and surgical intervention[J].Asian Spine J,2013,7(2):148-155.
[8] 王鹏,邓强,陈祁青,等.网袋加压椎体成形术治疗Kummell病12例[J].中国中医骨伤科杂志,2018,26(8):63-68.
[9] KIM J E,CHOI S S,LEE M K,et al. Failed percutaneous vertebroplasty due to insufficient correction of intravertebral instability in Kummell’s disease:a case report[J]. Pain Pract,2017,17( 8):1109-1114.
[10] PARK S J, KIM H S, LEE S K,et al. Bone cement-augmented percutaneous short segment fixation:an effective treatment for Kummell’s disease?[J]. J Korean Neurosurg Soc,2015,58(1):54-59.
[11] MA R,CHOW R,SHEN F H. Kummell’s disease:delayed post-traumatic osteonecrosis of the vertebral body[J]. Eur Spine J,2010,19(7):1065-1070.
[12] KANAYAMA M,ISHIDA T,HASHIMOTO T,et al. Role of major spine surgery using Kaneda anterior instrumentation for osteoporotic vertebral collapse[J].J Spinal Disord Tech,2010,23(1):53-56.
[13] YANG H,PAN J,WANG G. A review of osteoporotic vertebral fracture nonunion management[J]. Spine(Phila Pa 1976),2014,39(26):B4-B6.
[14] 邓轩赓,熊小明,万趸,等.单节段胸腰椎Ⅲ期 Kümmell 病短节段和长节段强化固定的临床比较研究[J].中国骨伤,2019,32(7):598-603.
[15] LIU F,CHEN Z,LOU C,et al. Anterior reconstruction versus posterior osteotomy in treating Kümmell’ s disease with neurological deficits:a systematic review[J]. Acta Orthop Traumatol Turc,2018,52(4):283-288.
[16] LIU F Y,HUO L S,LIU S,et al. Modified posterior vertebral column resection for Kummell disease[J]. Medicine(Baltimore),2017,96(5):e5955.
[17] SCHOENFELD A J, WOOD K B, FISHER C F,et al.Posttraumatic kyphosis:current state of diagnosis and treatment:results of a multinational survey of spine trauma surgeons[J].J Spinal Disord Tech,2010,23(7):1-8.
[18] 郝晨,关海山.两种手术方式治疗 Ⅲa 期 Kummell 病的比较[J].中国矫形外科杂志,2020,28(11):892-897.
[19] 陈景泉,徐展望.骨质疏松性脊柱骨折不愈合继发椎体塌陷的诊断和治疗研究[J].甘肃中医学院学报,2013,30(1):17-20.
[20] 常莹,麦筱莉,辛小燕,等.骨质疏松性椎体压缩骨折骨不连的X线平片和CT及 MRI影像学表现[J].中华实用诊断与治疗杂志,2019,33(3):279-282.
[21] PARK S J,KIM H S,LEE S K,et al. Bone cement-augmented percutaneous short segment fixation:an effective treatment for Kummell’s disease?[J]. J Korean Neurosurg Soc,2015,58(1):54-59.
[22] 王庆德,梅伟,张振辉,等.经椎弓根打压植骨与经后路椎体次全切除治疗Ⅲ期 Kümmell 病的对比研究[J].中医正骨,2018,30(6):415-433.
[23] 叶小伟,王华锋,刘伯龄.骨质疏松性椎体骨折不愈合的手术治疗进展[J].中国中医骨伤科杂志,2017,25(11):79-82.
[24] 童金玉,李新华,晏美俊,等.椎弓根皮质骨轨迹螺钉技术的研究进展[J].中国矫形外科杂志,2019,27(2):159-164.
[25] 赵世新,席海洋,王朕,等.皮质骨轨迹螺钉在脊柱外科中的应用进展[J].中国脊柱脊髓杂志,2019,29(12):1124-1128.

备注/Memo

备注/Memo:
基金项目:山东省中医药科技发展项目(2019-0794)
更新日期/Last Update: 2021-03-15