临床外科杂志 ›› 2023, Vol. 31 ›› Issue (11): 1081-1084.doi: 10.3969/j.issn.1005-6483.2023.11.022

• 论著 • 上一篇    下一篇

骨水泥网袋结合椎弓根锚定技术治疗Ⅲ期可复性Kummell病

  

  1. 430200  武汉市江夏区第一人民医院骨科(陈述伟、谈仁渊、雷宜松、刘安平、易莉艳 ) ;华中科技大学同济医学院附属协和医院骨科(吴星火)
  • 收稿日期:2023-04-04 接受日期:2023-04-04 出版日期:2023-11-20 发布日期:2023-11-20
  • 通讯作者: 陈述伟,Email: 1640681723@qq.com

Bone filling mesh bag combined with Pedicle anchoring For the treatment of Stage Ⅲ reducible Kummell disease

  1. Department of Orthopaedics,the First People’s Hospital of Jiangxia District,Wuhan 430200,China
  • Received:2023-04-04 Accepted:2023-04-04 Online:2023-11-20 Published:2023-11-20

摘要: 目的  探讨骨水泥网袋结合椎弓根锚定技术治疗Ⅲ期可复性Kummell病的临床疗效。方法 2018年1月~2022年12月收治的Ⅲ期可复性Kummell病病人35例,均采用骨水泥网袋结合椎弓根锚定技术治疗,记录手术时间、术中失血量、骨水泥注入量、手术并发症,比较手术前、术后次日及术后3个月随访时疼痛VAS评分、ODI值、Cobb角及伤椎中线高度。 结果 手术时间35~63分钟,平均(45±5.8)分钟,手术失血10~35ml,平均(20±5)ml,骨水泥注入量4.5~7.8ml,平均(5.5±1.8)ml,骨水泥漏4例,其中椎间隙漏1例,椎体侧漏2例,椎体前漏1例,无骨水泥椎管漏,所有骨水泥漏未导致临床症状,无骨水泥中毒及肺栓塞。无骨水泥团块滑移。所有病人均获得随访,随访时间12~24个月,平均(15±3.5)个月,VAS评分及Oswestry功能障碍指数(ODI)值术后第1天较术前明显降低,差异有统计学意义(P<0.05 ),术后3个月随访较术后第1天略增加,差异无统计学意义(P>0.05)。影像学测量伤椎中线高度及Cobb角情况,伤椎高度术后第1天较术前恢复明显恢复,Cobb角明显变小,差异有统计学意义(P<0.05 ),术后3个月随访伤椎中线高度较术后第1天变小,Cobb角稍增大,差异无统计学意义(P>0.05)。结论 骨水泥网袋结合椎弓根锚定技术治疗Ⅲ期可复性Kummell病疗效良好,能明显减轻病人疼痛,缓解临床症状,改善脊柱功能,提高生活质量,减少骨水泥渗漏及滑移发生率。

关键词: Kummell病Ⅲ期, 可复性, 骨水泥网袋, 椎弓根锚定技术, 微创

Abstract: Objective To investigate the clinical efficacy of bone filling mesh bag combined with pedicle anchoring for the treatment of Stage III reducible Kummell disease.Method The 35 paients with Stage Ⅲ  reducible Kummell disease were treated with bone filling mesh bag combined with pedicle anchoring from January 2018 to December 2022.The operation Time,intraoperative blood lose,bone cement injection volume and surgical complications were recorded.The VAS score,ODI value,kyphosis Cobb angle and midline height of the injured vertebral were compared at preoperative,postoperative 1 day and last follow-up.Results  All patients were followed up for 12-24months[(15±3.5)months].Operation time was 35-63min[(45±5.8)min],intraoperative blood loss was 10-35ml[(20±5)ml],bone cement injection volume was 4.5-7.8ml[(5.5±1.8)ml].There were 4 cases of bone cement leakage,there were 1 case of intervertebral leakage, 2 cases of lateral leakage,1 case of anterior leakage and no patient with intracanal leakage.All bone cement leakage did not lead to clinical symptoms, bone cement poisoning and pulmonary embolism. No cement mass slip. All patients were followed up for 12 to 24 months[(15±3.5)months].VAS scores and Oswestry Disability Index (ODI) values were significantly lower on the first day after surgery than before surgery, with statistical significance (P<0.05).The 3-month follow-up was slightly higher than that on the first day after surgery, and the difference was not statistically significant(P>0.05).The midline height and Cobb Angle of the injured vertebra were measured by imaging. The height of the injured vertebra recovered significantly on the first day after operation, and the Cobb Angle decreased significantly, the difference was statistically significant(P<0.05).The midline height of the injured vertebrae decreased and the Cobb Angle increased slightly at 3 months after the operation, but the difference was not statistically significant(P>0.05).Conclusion In the the treatment of Stage III reducible Kummell disease,Bone filling mesh bag combined with Pedicle anchoring have good clinical efficacy,which can significantly reduce the pain of patients,relieve clinical symptoms,improve spinal function,improve quality of life,and reduce the incidence of bone cement leakage and slippage.

Key words: Kummell disease with Stage Ⅲ;recoverability;bone filling mesh bag;pedicle anchoring, minimally invasive

[1] 姜兆磊 梅举. 微创Morrow联合二尖瓣缘对缘修复技术治疗肥厚型梗阻性心肌病[J]. 临床外科杂志, 2023, 31(9): 808-810.
[2] 胡家瑞 宋明 余来. 经皮微创与开放手术治疗胸腰椎骨折的疗效及安全性分析[J]. 临床外科杂志, 2023, 31(9): 881-884.
[3] 刘智敏 任东林. 复杂性肛瘘诊疗中的挑战与展望[J]. 临床外科杂志, 2023, 31(6): 501-505.
[4] 柯磊 张庆怡 汪路明 周春琳 马洪海 俞豪杰 何哲浩 胡坚. 可塑性蛇形腔镜手术辅助臂的临床研究[J]. 临床外科杂志, 2023, 31(6): 568-570.
[5] 王世丽 吴谋东 安妮妮 马洪. 机器人在小儿泌尿疾病中的应用现状与展望[J]. 临床外科杂志, 2023, 31(5): 407-410.
[6] 张玉茹 陈江龙 林珊 何少华 徐迪. 单孔腹腔镜研究进展及其在小儿外科中的应用[J]. 临床外科杂志, 2023, 31(5): 411-414.
[7] 徐玲 潘华锋. 微创旋切术、开放手术、穿刺抽液术治疗脓肿期浆细胞性乳腺炎的疗效分析[J]. 临床外科杂志, 2023, 31(3): 223-226.
[8] 周永智 魏翔 邓朋 王靖 杨建业 王星宇 胡敏. 经胸骨上段小切口行A型主动脉夹层手术[J]. 临床外科杂志, 2023, 31(3): 238-241.
[9] 邓朝强 张宁 傅方求 张扬 陈海泉. 肺癌微创3.0的再认识和实践[J]. 临床外科杂志, 2022, 30(8): 701-704.
[10] 岳鹏举 章其祝 薛书生 吴琪. 微创直接前入路与SuperPATH入路行全髋关节置换术后早期平衡及功能恢复的差异对比[J]. 临床外科杂志, 2022, 30(8): 775-779.
[11] 刘丹希 孙备. 重症急性胰腺炎治疗的热点问题[J]. 临床外科杂志, 2022, 30(7): 617-620.
[12] 许卫兵 付豪. 双通道脊柱内镜技术治疗腰椎管狭窄症[J]. 临床外科杂志, 2022, 30(4): 309-312.
[13] 中国医师协会急救复苏专业委员会创伤骨科与多发伤学组 中国医药教育学会骨质疾病专业委员会修复重建学组 中国老年学和老年医学学会老年病分会骨科专家委员会 中华医学会骨科学分会青年骨质疏松学组/曹发奇 闫晨晨 薛航 苏佳灿 张英泽 刘国辉. 中国老年髋部骨折病人行微创手术治疗专家共识[J]. 临床外科杂志, 2022, 30(4): 394-400.
[14] 明炜 吕建发 刘高利 侯国强 胡海峰 龙杏林 张文涵 谢颂平. 胸腔镜下全食管系膜切除术在食管癌根治术中的应用分析[J]. 临床外科杂志, 2021, 29(9): 827-829.
[15] 罗文浩 邱江东 张太平. 胰腺微创手术的进展和展望[J]. 临床外科杂志, 2021, 29(7): 601-603.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 张忠伟;刘扬;路明. 痔上黏膜环切术治疗直肠前突所致出口梗阻型便秘的疗效观察[J]. 临床外科杂志, 2016, 24(10): 774 .
[2] 张业强;晏大学;高小见 . 急诊肋骨内固定手术对严重连枷胸患者恢复的影响[J]. 临床外科杂志, 2016, 24(10): 794 .
[3] 易凡;尚玉强;夏家红;等. 重症瓣膜病患者围手术期营养支持治疗体会[J]. 临床外科杂志, 2016, 24(12): 912 .
[4] 熊元;刘国辉;夏天等. 有限内固定结合踝关节外固定架治疗复杂开放性踝关节骨折46例[J]. 临床外科杂志, 2016, 24(5): 356 -0 .
[5] 赵文斌;凃峰;张晨等. 肱骨近端锁定钢板与近端锁定钢板联合内侧普通钢板治疗肱骨近端骨折合并中段骨折的疗效分析[J]. 临床外科杂志, 2016, 24(5): 359 -0 .
[6] 吴超;汪全新;卢晓明 . 腹腔镜改良经肛门结肠肛管吻合术切除低位直肠癌保肛手术的临床疗效分析 [J]. 临床外科杂志, 2016, 24(6): 437 .
[7] 赵军. 肺癌靶向治疗进展[J]. 临床外科杂志, 2016, 24(7): 514 .
[8] 梁寒. 腹腔热灌注化疗技术临床应用专家共识(2016版)解读——胃癌腹膜转移的防治[J]. 临床外科杂志, 2017, 25(1): 20 .
[9] 李学荣;陈永平;秋实;等. 腰椎休门氏病伴脊柱侧弯畸形一例[J]. 临床外科杂志, 2017, 25(11): 880 .
[10] 颛孙迪迪;冯杰雄. 大数据时代下先天性巨结肠临床研究的展望[J]. 临床外科杂志, 2017, 25(12): 885 .