BACKGROUND:In recent years, percutaneous vertebroplasty (PVP) has provided a new option for the treatment of Kümmell's disease (KD). This retrospective study aimed to investigate the differences in clinical characteristics, clinical efficacy, and related complications between two types of bone cement distribution patterns in the PVP treatment of KD. METHODS:A total of 63 patients with KD from January 2016 to February 2018 who received PVP treatment were examined at least 24 months. According to X-ray distribution modes of bone cement after PVP treatment, they were divided into 2 groups: blocky group (30 cases) and spongy group (33 cases). Clinical features and disease severity preoperatively, and clinical efficacy and related complications postoperatively were statistically compared between the two groups. RESULTS:The two groups were followed for at least 24 months. The duration of disease, age, Cobb angle, and vertebral compression rate preoperatively were significantly higher in the blocky group than in the spongy group (P < 0.05, respectively). The height of vertebral anterior margin and BMD were significantly lower in the blocky group than in the spongy group (P < 0.05, respectively). The amount of bone cement injected was significantly greater in the blocky group than in the spongy group (P = 0.000). VAS and ODI of the two groups were significantly reduced at the first day, the first year, and the last follow-up postoperatively (all P = 0.000) and were maintained at the last follow-up. VAS and ODI postoperatively decreased significantly in the spongy group compared with the blocky group (P = 0.000). The correction degrees of kyphosis and vertebral compression postoperatively in the two groups were significantly corrected, but gradually decreased over time (P < 0.05), and these correction degrees were significantly higher in the blocky group than in the spongy group, and the postoperative losses were also more serious. CONCLUSIONS:The disease was more serious in the blocky group than in the spongy group. The amount of bone cement, correction degrees of postoperative kyphosis and vertebral compression were significantly higher in the blocky group than in the spongy group, but its postoperative losses of the correction degrees of kyphosis and vertebral compression were also more serious. However, for pain relief and functional recovery, the spongy group was superior to the blocky group. Therefore, the spongy distribution pattern should be formed during the injection of bone cement to obtain better therapeutic effect.

译文

背景:近年来,经皮椎体成形术(PVP)为治疗Kümmell病(KD)提供了新的选择。这项回顾性研究旨在调查在KD的PVP治疗中两种类型的骨水泥分布模式之间的临床特征,临床疗效和相关并发症之间的差异。
方法:从2016年1月至2018年2月,共63例接受PVP治疗的KD患者接受了至少24个月的检查。根据PVP治疗后骨水泥的X射线分布方式,分为块状组(30例)和海绵状组(33例)2组。对两组患者术前的临床特征和疾病严重程度以及术后的临床疗效和相关并发症进行统计学比较。
结果:两组均随访至少24个月。阻塞性组的病程,年龄,科布角和椎体压缩率在术前明显高于海绵组(分别为P <0.05)。块状组的椎前缘高度和骨密度显着低于海绵状组(分别为P <0.05)。块状组的骨水泥注射量明显大于海绵状组(P = 0.000)。两组的VAS和ODI在术后第一天,第一年和最后一次随访中均显着降低(所有P = 0.000),并在最后一次随访中得以维持。与块状组相比,海绵状组术后VAS和ODI显着降低(P = 0.000)。两组术后后凸畸形和椎体压缩的矫正度得到了明显矫正,但随着时间的推移逐渐降低(P <0.05),而阻塞组的这些矫正度显着高于海绵状组,且术后损失为也比较严重。
结论:阻塞性疾病的发生率比海绵状组高。块状组的骨水泥含量,术后后凸畸形和椎体受压的矫正度均显着高于海绵状组,但其术后后凸畸形和椎体受压的矫正度损失也更为严重。但是,为了缓解疼痛和恢复功能,海绵状组优于块状组。因此,在骨水泥注射过程中应形成海绵状分布图案,以获得更好的治疗效果。

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