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Abstract：
BACKGROUND: The standard treatment for Kummell disease with neurologic deficit remains controversial. Traditional posterior long-segment fixation (LSF) has been widely used, but the procedure results in significant trauma and carries the risk of multiple complications. Therefore, bone cement-augmented short-segment fixation (BCASSF) has been recommended for this condition.
METHODS: The study included 36 patients treated with LSF or BCASSF between January 2012 and June 2015. The visual analog scale (VAS), Oswestry Disability Index (ODI) score, anterior height of fractured vertebrae, kyphotic Cobb angle, and neurologic function by the Frankel classification were evaluated and compared, and duration of operation, blood loss, length of hospital stay, and complications were recorded.
RESULTS: Significant differences were observed in the VAS, ODI, anterior height of affected vertebrae, and kyphotic Cobb angle between preoperatively and 7 days postoperatively and between preoperatively and at the final follow-up, whereas no significant differences were observed between 7 days postoperatively and at final follow-up. No significant differences in the aforementioned parameters were observed between the groups at 7 days postoperatively and at the final follow-up. Neurologic function was improved in both groups; however, no significant differences were observed between the 2 groups either preoperatively or postoperatively. Blood loss and length of hospital stay were significantly lower in the BCASSF group compared with the LSF group, but no significant between-group differences were observed in operation time and complications.
CONCLUSIONS: Lower blood loss and shorter hospital stay were associated with BCASSF compared with LSF; the 2 techniques had similar clinical outcomes and radiographic findings. Therefore, we recommend BCASSF for treating patients with Kummell disease with neurologic deficits.
METHODS: The study included 36 patients treated with LSF or BCASSF between January 2012 and June 2015. The visual analog scale (VAS), Oswestry Disability Index (ODI) score, anterior height of fractured vertebrae, kyphotic Cobb angle, and neurologic function by the Frankel classification were evaluated and compared, and duration of operation, blood loss, length of hospital stay, and complications were recorded.
RESULTS: Significant differences were observed in the VAS, ODI, anterior height of affected vertebrae, and kyphotic Cobb angle between preoperatively and 7 days postoperatively and between preoperatively and at the final follow-up, whereas no significant differences were observed between 7 days postoperatively and at final follow-up. No significant differences in the aforementioned parameters were observed between the groups at 7 days postoperatively and at the final follow-up. Neurologic function was improved in both groups; however, no significant differences were observed between the 2 groups either preoperatively or postoperatively. Blood loss and length of hospital stay were significantly lower in the BCASSF group compared with the LSF group, but no significant between-group differences were observed in operation time and complications.
CONCLUSIONS: Lower blood loss and shorter hospital stay were associated with BCASSF compared with LSF; the 2 techniques had similar clinical outcomes and radiographic findings. Therefore, we recommend BCASSF for treating patients with Kummell disease with neurologic deficits.
摘要：
背景：对于伴有神经缺陷的库默病的标准治疗仍存在争议。传统的后路长节段固定术(LSF)得到了广泛的应用,但该手术会导致严重的创伤，并有多种并发症的风险。因此,骨水泥增强短节段固定（BCASF）已被推荐用于这种情况。
方法：该研究包括2012年1月至2015年6月期间接受LSF或BCASF治疗的36例患者。视觉模拟量表(VAS),Oswestry残疾指数(ODI)评分,骨折椎骨前高度，后凸Cobb角,并通过Frankel分类对神经功能进行了评估和比较，和操作持续时间，失血,住院时间,并记录并发症。
结果：在VAS中观察到显着差异，ODI,受累椎骨前高度，术前和术后7天之间以及术前和最终随访之间的后凸Cobb角，而术后7天和最终随访时没有观察到显著差异.术后7天和最后随访时，两组间上述参数均无显著差异。两组的神经功能均得到改善；然而，两组术前或术后均无显著差异.与LSF组相比,BCASF组的失血量和住院时间显著减少,但两组在手术时间和并发症方面差异无统计学意义。
结论：与LSF相比，BCASF的失血量和住院时间更短；两种技术的临床结果和影像学检查结果相似。因此,我们推荐BCASF用于治疗伴有神经功能缺损的Kummell病患者.
方法：该研究包括2012年1月至2015年6月期间接受LSF或BCASF治疗的36例患者。视觉模拟量表(VAS),Oswestry残疾指数(ODI)评分,骨折椎骨前高度，后凸Cobb角,并通过Frankel分类对神经功能进行了评估和比较，和操作持续时间，失血,住院时间,并记录并发症。
结果：在VAS中观察到显着差异，ODI,受累椎骨前高度，术前和术后7天之间以及术前和最终随访之间的后凸Cobb角，而术后7天和最终随访时没有观察到显著差异.术后7天和最后随访时，两组间上述参数均无显著差异。两组的神经功能均得到改善；然而，两组术前或术后均无显著差异.与LSF组相比,BCASF组的失血量和住院时间显著减少,但两组在手术时间和并发症方面差异无统计学意义。
结论：与LSF相比，BCASF的失血量和住院时间更短；两种技术的临床结果和影像学检查结果相似。因此,我们推荐BCASF用于治疗伴有神经功能缺损的Kummell病患者.
