| 朱科林,吴承钧,张建乔,等.单侧经椎弓根外裂隙靶点穿刺PKP治疗Ⅰ、Ⅱ期Kümmell病的临床疗效观察.骨科,2026,17(4): 312-317. |
| 单侧经椎弓根外裂隙靶点穿刺PKP治疗Ⅰ、Ⅱ期Kümmell病的临床疗效观察 |
| Clinical efficacy of unilateral extrapedicular fissure-targeted percutaneous kyphoplasty for stage Ⅰ and Ⅱ Kümmell disease |
| 投稿时间：2025-10-04 |
| DOI：10.3969/j.issn.1674-8573.2026.04.002 |
| CN KeyWords: Kümmell病 经皮椎体后凸成形术 椎体裂隙 经椎弓根外穿刺 靶点穿刺 |
| EN KeyWords: Kümmell disease Percutaneous kyphoplasty Vertebral fissure Extrapedicular puncture Target puncture |
| Fund Project:浙江省中医药科技计划项目（2025ZL555）；浙江省中医药重点专科建设项目；嘉兴市市级临床重点专科建设项目 |
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| CN Abstract: |
| 目的 比较单侧经椎弓根外椎体裂隙靶点穿刺椎体后凸成形术（PKP）与经双侧椎弓根穿刺PKP治疗Ⅰ、Ⅱ期Kümmell病的临床疗效。方法 回顾性分析2018年12月至2022年12月在本院确诊为Ⅰ、Ⅱ期Kümmell病且行PKP治疗的50例患者的病例资料。22例行单侧经椎弓根外裂隙靶点穿刺PKP（实验组），28例行经双侧椎弓根穿刺PKP（对照组）。比较两组手术时间、骨水泥注入量、骨水泥渗漏发生率，记录两组术前、术后1周、术后1个月、末次随访时的疼痛视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）、伤椎前缘高度比及伤椎后凸Cobb角变化。结果 50例患者均顺利完成手术，完成随访；实验组手术时间为（39.50±3.08） min，显著低于对照组的（46.46±4.55） min，差异有统计学意义（P<0.05）；两组术中各发生3例骨水泥渗漏，未出现临床症状，骨水泥注入量、骨水泥渗漏率组间差异无统计学意义（P>0.05）。实验组与对照组术后VAS评分、ODI、伤椎前缘高度比及伤椎后凸Cobb角均较术前有明显改善（P<0.05），但组间比较，差异无统计学意义（P>0.05）。结论 采用单侧经椎弓根外裂隙靶点穿刺PKP治疗Ⅰ、Ⅱ期Kümmell病是一种可靠、安全、有效的术式，值得临床推广应用。 |
| EN Abstract: |
| Objective To compare the clinical efficacy of unilateral extrapedicular fissure-targeted percutaneous kyphoplasty (PKP) via the pedicle versus bilateral transpedicular PKP in the treatment of stage Ⅰand Ⅱ Kümmell disease. Methods A retrospective analysis was conducted on 50 patients diagnosed with stage Ⅰ or Ⅱ Kümmell disease who underwent PKP in our hospital between December 2018 and December 2022. Among them, 22 patients received unilateral extrapedicular fissure-targeted PKP (experimental group), and 28 patients underwent bilateral transpedicular PKP (control group). The operation time, cement injection volume, and cement leakage rate were compared between the two groups. Pain visual analogue scale (VAS) score, Oswestry disability index (ODI), anterior vertebral body height ratio, and kyphotic Cobb angle of the injured vertebra were recorded preoperatively, at 1 week, and 1 month postoperatively, and at the last follow-up. Results All 50 patients completed the surgery and follow-up. The operation time in the experimental group was significantly shorter than that in the control group [(39.50±3.08) min vs. (46.46±4.55) min, P<0.05]. Three cases of cement leakage occurred in each group during surgery, but none were symptomatic. There was no significant between-group differences in cement injection volume or cement leakage rate (P>0.05). Postoperative VAS scores, ODI, anterior vertebral body height ratio, and kyphotic Cobb angle were significantly improved in both groups compared with preoperative values (P<0.05); however, no significant differences were found between the groups (P>0.05). Conclusion Unilateral extrapedicular fissure-targeted PKP is a reliable, safe, and effective procedure for the treatment of stage Ⅰ and Ⅱ Kümmell disease, and may be worthy of clinical promotion. |
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