【摘要】 目的比较经皮椎体后凸成形术(PKP)与短节段椎弓根螺钉固定结合骨水泥增强(PSF+BCA)治疗Kummell病的临床疗效。方法将80例Kummell病患者根据手术方式不同分为PKP组(44例)和PSF+BCA组(36例)。比较两组手术时间、术中出血量、术中透视时间、住院时间及并发症。术后3 d及1年采用ODI评分、腰背部疼痛VAS评分以及测量Cobb角评价临床疗效。结果患者均获得随访,时间12～56个月。手术时间、术中出血量、住院时间PKP组短(少)于PSF+BCA组(P <0.05),术中透视时间PKP组长于PSF+BCA组(P <0.05)。两组术后3 d及1年的VAS评分、ODI评分、Cobb角均较术前明显改善(P <0.05),VAS评分术后1年明显优于术后3 d(P <0.05)。术后3 d,VAS评分、ODI评分PKP组均明显优于PSF+BCA组(P <0.01);术后1年两组各项指标比较差异均无统计学意义(P> 0.05)。结论 PKP及PSF+BCA都是治疗Kummell病的有效手段,但PKP在手术时间、住院时间、术中出血量、并发症发生率、临床疗效方面优于PSF+BCA。更多还原

【Abstract】 Objective To compare the clinical efficacy of percutaneous kyphoplasty( PKP) with short segment pedicle screw fixation combined with bone cement-augmentation( PSF + BCA) in the treatment of Kummell disease.Methods Eighty patients with Kummell disease were divided into PKP group( 44 cases) and PSF + BCA group( 36 cases) according to different surgical methods.Operation time,intraoperative blood loss,intraoperative fluoroscopy time,length of hospital stay and complications were compared between the two group.ODI,pain VAS of the low back and Cobb angle were used to evaluate the clinical efficacy at 3 d and 1 year after operation.Results All patients were followed up for 12 ～ 56 months.The operation time,intraoperative blood loss,and length of hospital stay were shorter( less) in the PKP group than those in the PSF + BCA group( P <0.05),and the intraoperative fluoroscopy time was longer in the PKP group than in the PSF + BCA group( P < 0.05).The VAS,ODI,and Cobb angle at 3 d and 1 year after operation were significantly improved in both groups than before surgery( P < 0.05).The VAS at 1 year after operation was significantly better than that at 3 d after operation( P < 0.05).The VAS and ODI of the PKP group were significantly better than those of the PSF + BCA group at 3 d after operation( P < 0.01).At 1 year postoperation,there were no significant differences for various indicators between the two groups( P > 0.05).Conclusions PKP technique and PSF + BCA technique are both effective means to treat Kummell disease,but PKP technique is superior to PSF + BCA technique in operation time,length of hospital stay,intraoperative blood loss and complication incidence rate,clinical efficacy for Kummell disease.更多还原