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目的 对比单侧经椎弓根外侧入路及双侧经椎弓根入路经皮椎体后凸成形术（PKP）治疗Ⅰ、Ⅱ期Kümmell's病的临床效果。方法 回顾性分析2019年1月至2022年1月67例在广东药科大学附属第一医院行PKP的Kümmell's病患者的临床资料。根据手术入路的不同分为两组，其中单侧组31例，采取单侧经椎弓根外侧入路，双侧组36例，采取双侧经椎弓根入路。比较两组手术时间、术后住院时间、视觉模拟量表（VAS）评分、Cobb角、骨水泥注入量、骨水泥渗漏发生率的差异。结果 两组患者术后住院时间、手术前后VAS评分和Cobb角比较，差异无统计学意义（P >0.05）。单侧组手术时间、骨水泥注入量少于双侧组，两组比较，差异有统计学意义（P<0.05）。与术前比较，两组患者术后1 d、12个月VAS评分和Cobb角均有明显改善（P<0.05）。单侧组和双侧组骨水泥渗漏发生率差异不大（29.03%vs 13.89%,P >0.05），渗漏患者均无神经损伤表现。结论 单侧经椎弓根外侧入路与双侧经椎弓根入路PKP治疗Ⅰ、Ⅱ期Kümmell's病均可取得满意疗效，前者手术时间更短，骨水泥注入量更少，安全性良好。
Abstract：Objective To compare the efficacy between unilateral transpedicular lateral approach and bilateral transpedicular approach for percutaneous kyphoplasty(PKP) in the treatment of stage Ⅰ and ⅡKümmell's disease. Methods Clinical data of 67 patients with Kümmell's disease treated by PKP in First Affiliated Hospital of Guangdong Pharmaceutical University from January 2019 to January 2022 were analyzed retrospectively. According to different surgical approaches, patients were divided into two groups, unilateral group and bilateral group. Thirty-one patients in unilateral group were performed PKP by unilateral transpedicular external approach, and 36 patients in bilateral group were performed PKP by bilateral transpedicular approach.Operation time, postoperative hospital stay, visual analogue scale(VAS) score, Cobb angle, bone cement injection volume, and bone cement leakage rate were compared between the two groups. Results There were no statistical differences in postoperative hospital stay, preoperative and postoperative VAS score and Cobb angle between the two groups(P >0.05). The operation time and the amount of bone cement in the unilateral group were significantly less than those in the bilateral group(P <0.05). Both groups showed significant improvement in VAS scores and Cobb angle at 1 day and 12 months postoperatively when compared with preoperative ones(P <0.05). There was no significant difference in the incidence of bone cement leakage between the two groups(29.03% in unilateral goup vs 13.89% in bilateral group, P >0.05). No signs of nerve damage was found in patients with bone cement leakage. Conclusions PKP by unilateral transpedicular lateral approach and bilateral transpedicular approach could both achieve satisfactory effects for the treatment of stage Ⅰ and Ⅱ Kümmell's disease, and the former approach has the advantages of less operative time, lower bone cement injection volume,and good operation security.
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基本信息:
DOI：
中图分类号:R687.3
引用信息:
[1]黄旭胜,葛冬冬,王健等.单侧经椎弓根外侧入路与双侧经椎弓根入路椎体后凸成形术治疗Ⅰ、Ⅱ期Kümmell's病的疗效对比[J].中国骨科临床与基础研究杂志,2025,15(02):96-102.
基金信息:
广东省中医药局科研项目(20251223)