[1]郭俊彪,王慧敏,邓晓强,等.脊神经后支封闭联合经皮椎体后凸成形术治疗Ⅰ、Ⅱ期Kmmell病腰背部疼痛[J].中医正骨,2018,30(06):50-52.
点击复制

脊神经后支封闭联合经皮椎体后凸成形术治疗Ⅰ、Ⅱ期Kümmell 病腰背部疼痛()
分享到：

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年06期
页码:
50-52
栏目:
kümmell病
出版日期:
2018-06-20

文章信息/Info

作者:
郭俊彪; 王慧敏; 邓晓强; 黄磺
广东省中医院,广东 广州 510120
关键词:
腰痛;  脊柱骨折;  Kü; mmell病;  脊神经;  封闭疗法;  椎体后凸成形术
文献标志码:
A
摘要:
目的:观察脊神经后支封闭联合经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗Ⅰ、Ⅱ期Kümmell病腰背部疼痛的临床疗效。方法:2014年11月至2016年11月收治20例Ⅰ、Ⅱ期Kümmell病患者。男7例,女13例; 年龄65～83岁,中位数73岁; 均为单椎体病变,T12椎体骨折7例、L1椎体骨折8例、L2椎体骨折3例、L3椎体骨折2例。所有患者均不合并严重内科疾病,近2周内未服用过止痛药物。均采用脊神经后支封闭联合PKP治疗,术前、术后常规进行抗骨质疏松治疗,但均不使用止痛药物。结果:所有患者均顺利完成手术。14例患者在穿刺过程中出现腰背部疼痛及大腿外侧疼痛,但未向大腿前侧及小腿放射,术后疼痛均明显缓解,2例残余轻度疼痛。术前、术后1 d、术后1个月时,患者的腰背部疼痛视觉模拟评分分别为(6.58±1.79)分、(1.55±1.26)分、(1.48±0.87)分,Oswestry功能障碍指数分别为(64.38±9.89)%、(21.08±7.02)%、(13.69±3.02)%。结论:脊神经后支封闭联合PKP可有效减轻Ⅰ、Ⅱ期Kümmell病患者的腰背部疼痛症状。

参考文献/References:

[1] STEEL HH.Kümmell's disease[J].Am J Surg,1951,81(2):161-167. [2] LI KC,WONG TU,KUNG FC,et al.Staging of kümmell's disease[J].J Musculoskelet Res,2004,8(1):43-55. [3] WU AM,CHI YL,NI WF.Vertebral compression fracture with intravertebral vacuum cleft sign:pathogenesis,image,and surgical intervention[J].Asian Spine J,2013,7(2):148-155. [4] MATZAROGLOU C,GEORGIOU CS,ASSIMAKOPOULOS K,et al.Kümmell' s disease:A rare spine entity in a young adult[J].Hell J Nucl Med,2010,13(1):52-55. [5] 张磊磊,李健.Kummell病的研究进展[J].中国矫形外科杂志,2015,23(9):816-819. [6] YU W,LIANG,YAO Z,et al.The therapeutic effect of intravertebral vacuum cleft with osteoporotic vertebral compression fractures:A systematic review and meta-analysis[J].Int J Surg,2017,40:17-23. [7] HE DW,YU WY,CHEN ZZ,et al.Pathogenesis of the intravertebral vacuum of Kummell's disease(Review)[J].Exp Ther Med,2016,12(2):879-882. [8] 胡焓,荆萍,乔杰,等.腰椎脊神经后内侧支射频热凝术治疗老年人腰椎小关节源性腰痛的临床研究[J].数理医药学杂志,2017,30(9):1283-1285. [9] RATCLIFFE JF.The arterial anatomy of the adult human lumbar vertebral body:a microarteriographic study[J].J Anat,1980,131(Pt 1):57-79. [10] DAVIASON JH.Manipulation for low back pain[J].Br Med J,1978,2(6152):1644-1645. [11] MOONEY V, ROBERTSON J.The facet syndrome[J].Clin Orthop Relat Res,1976,(115):149-156. [12] 向醒,杨晶,张平,等.超声引导下腰椎小关节阻滞缓解经皮椎体后凸成形术术后残余疼痛[J].中国介入影像与治疗学,2017,14(6):360-364. [13] 梁冬波,李剑峰,王力平.经皮穿刺椎体成形术术后残余腰痛的相关因素分析[J].微创医学,2017,12(4):479- 482. [14] 唐福宇,覃智斌,王继.脊柱骨折椎体成形术与椎体后凸成形术的术后疼痛原因分析及防治进展[J].广西中医药,2017,40(3):19-22. [15] 李鹏,杨春,蔡静桐,等.腰椎小关节周围脊神经后支内侧支分布的特点及其临床意义[J].局解手术学杂志,2017,26(8):552-555. [16] COHEN SP,HUANG JH,BRUMMETT C.Facet joint pain-advances in patient selection and treatment[J].Nat Rev Rheumatol,2013,9(2):101-116.

相似文献/References:

[1]宁兴明,伍亮,王廷,等.五禽戏配合核心肌力训练治疗非特异性腰痛的临床研究[J].中医正骨,2015,27(11):25.
　NING Xingming,WU Liang,WANG Ting,et al.Clinical study on five mimic-animal boxing combined with core muscular strength exercise for the treatment of nonspecific low back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(06):25.
[2]张亮,张莉,王莉佳,等.快速康复外科理念在椎弓根螺钉内固定治疗 胸腰椎骨折围手术期护理中的应用[J].中医正骨,2015,27(06):75.
[3]金立昆,齐越峰,唐可,等.中药离子导入联合腰背部功能锻炼治疗 非特异性腰痛的临床研究[J].中医正骨,2016,28(01):20.
　JIN Likun,QI Yuefeng,TANG Ke,et al.Clinical study on iontophoresis of traditional Chinese medicine combined with lower back functional exercise for treatment of non-specific low back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(06):20.
[4]杨勇,王雷生,张娟.经椎关节突关节温针治疗腰椎关节突关节源性腰痛[J].中医正骨,2016,28(02):67.
[5]孙兰芬,王龙强,刘润宏,等.颈椎骨折脱位合并脊髓损伤截瘫患者的围手术期护理[J].中医正骨,2016,28(03):79.
[6]袁启令,刘亮,马江涛,等.针刺治疗慢性非特异性腰痛的临床研究[J].中医正骨,2016,28(06):12.
　YUAN Qiling,LIU Liang,MA Jiangtao,et al.A clinical study of acupuncture therapy for treatment of chronic nonspecific low back pain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(06):12.
[7]梅 伟.胸腰椎骨折临床诊疗中的热点问题[J].中医正骨,2016,28(07):1.
[8]徐无忌,刘晓岚.体位复位结合经皮椎体成形术与经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的对比研究[J].中医正骨,2016,28(07):20.
　XU Wuji,LIU Xiaolan.Effect of Qianggu Yin(强骨饮,QGY)on bone microstructure in the ovariectomized osteoporosis rats[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(06):20.
[9]李英周,叶锋,王晓,等.后路撬拨植骨椎弓根螺钉内固定治疗胸腰椎骨折[J].中医正骨,2016,28(07):46.
[10]王军,陈哲,王硕凡.胸腰椎骨折椎体植骨材料的临床应用进展[J].中医正骨,2016,28(07):64.
[11]张会,鄢卫平,刘卫义,等.骨质疏松性椎体压缩骨折椎体强化术后残余腰背痛的影响因素分析[J].中医正骨,2024,36(08):31.
　ZHANG Hui,YAN Weiping,LIU Weiyi,et al.Factors influencing residual low back pain after vertebral augmentation for treatment of osteoporotic vertebral compression fracture[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(06):31.

更新日期/Last Update: 2018-10-30