广西医学

目的　探讨骨水泥拖尾技术在经皮椎体后凸成形术（PKP）治疗Kümmell病中的应用效果。方法　回顾性分析40例行PKP治疗的Kümmell病患者的临床资料，根据术中是否使用骨水泥拖尾技术分为非拖尾组（n=18）及拖尾组（n=22）。比较两组患者围手术期指标（手术时间、术中透视次数、术中出血量、骨水泥注入量及住院时间），手术前后腰痛视觉模拟量表（VAS）评分、胸腰椎功能［Oswestry功能障碍指数（ODI）评分、Cobb角、病变椎体前缘相对高度］、生活质量［健康调查问卷简表（SF⁃36）］，以及术后1年并发症发生情况。结果　（1）两组患者手术时间、术中透视次数、术中出血量、骨水泥注入量及住院时间比较，差异无统计学意义（P>0.05）。（2）术后，两组患者的腰痛VAS评分、ODI评分及拖尾组的Cobb角有随时间降低或减小的趋势，两组患者的SF⁃36得分、病变椎体前缘相对高度有随时间增高的趋势（P<0.05）；术后1 d及1年，非拖尾组患者的Cobb角均小于术前（P<0.05）。术后1 d及1年，与非拖尾组相比，拖尾组患者的腰痛VAS评分、ODI评分更低，Cobb角更小，SF⁃36得分、病变椎体前缘相对高度更高（P<0.05）。（3）两组患者并发症发生率比较，差异无统计学意义（P>0.05）。结论　在PKP治疗Kümmell病中应用骨水泥拖尾技术的治疗效果优于未使用骨水泥拖尾技术，该技术能更有效地缓解Kümmell病患者术后腰痛，促进胸腰椎功能恢复，提高生活质量，且安全性较好。

Objective　To explore the application effect of bone cement tailoring technique in percutaneous kyphoplasty (PKP) for treating Kümmell's disease. Methods　The clinical data of 40 patients with Kümmell's disease undergoing PKP therapy were retrospectively analyzed. Patients were divided into non⁃tailoring group (n=18) or tailoring group (n=22) according to whether bone cement tailoring technique was applied or not during surgery. Perioperative indices (operation duration, intraoperative fluoroscopy frequency, intraoperative bleeding loss, injection volume of bone cement, length of hospital stay), and pre⁃ and postoperative Visual Analog Scale (VAS) score for low back pain, lumbar vertebral function ［Oswestry disability index (ODI) score, Cobb angle, relative height of anterior edge of affected vertebra］, quality of life (36⁃Item Short⁃Form Health Survey ［SF⁃36］), and the occurrence of 1⁃year postoperative complications were compared between the two groups. Results　(1) No statistically significant difference was observed in operation duration, intraoperative fluoroscopy frequency, intraoperative bleeding loss, injection volume of bone cement, and length of hospital stay between the two groups (P>0.05). (2) After surgery, VAS score for low back pain, ODI score of both groups, and Cobb angle in the tailoring group exhibited a trend of decline over time, whereas SF⁃36 score and relative height of anterior edge of affected vertebra of both groups revealed a trend of increase over time (P<0.05). One day and one year after surgery, Cobb angle of the non⁃tailoring group was smaller as compared with before surgery (P<0.05). One day and one year after surgery, compared with the non⁃tailoring group, the tailoring group exhibited lower VAS score for low back pain, ODI score, and smaller Cobb angle, whereas higher SF⁃36 score and relative height of anterior edge of affected vertebra (P<0.05). (3) There was no statistically significant difference in the incidence rate of complications between the two groups (P>0.05). Conclusion The application of bone cement tailoring technique in PKP for the treatment of Kümmell's disease is superior to that without bone cement tailoring technique. The technique can effectively relieve the postoperative low back pain of patients with Kümmell's disease, promote the recovery of lumbar vertebral function, improve the quality of life, exerting a favorable safety.