METHODS: The patient was a 72-year-old female who presented unexplained lower back pain accompanied with limited mobility for the past three months. Based on her medical history, physical examinations, and imaging studies, it was confirmed that she had Kummell\'s disease in stage III without neurological symptoms. We treated her with percutaneous bone cement-augmented short-segment pedicle screw fixation combined with percutaneous vertebroplasty on the symptomatic vertebrae.
UNASSIGNED: The majority of patients with stage III Kummell\'s disease have severe osteoporosis, which result in failure of the internal fixation and a series of other complications. Maintaining the stability of the internal fixation system is crucial, especially after screwing and subsequent locking. When augmented with bone cement, the grip and pull-out resistance of the percutaneous pedicle screws enhance greatly. Simultaneously, percutaneous vertebroplasty on the symptomatic vertebrae can immediately support the spine unit\'s stability mechanically and maintain the shape of the vertebrae after reduction.
CONCLUSIONS: The percutaneous bone cement-augmented short-segment pedicle screw fixation combined with percutaneous vertebroplasty on the symptomatic vertebrae is an effective treatment for stage III Kummell\'s disease without neurological symptoms. It can effectively restore the vertebral height, correct the kyphotic deformities, improve spinal canal stenosis, and achieve satisfactory short-term clinical outcomes.
方法:患者是一名72岁女性,在过去三个月中出现无法解释的下背部疼痛并伴有活动受限。根据她的病史,体检,和成像研究,经证实,她患有Kummell病III期,无神经症状。我们在有症状的椎骨上通过经皮骨水泥增强短节段椎弓根螺钉固定结合经皮椎体成形术治疗了她。
■大多数III期Kummell病患者患有严重的骨质疏松症,导致内固定失败和一系列其他并发症。保持内固定系统的稳定性至关重要,尤其是在拧紧和随后的锁定之后。用骨水泥增强时,经皮椎弓根螺钉的抓地力和拔出阻力大大提高。同时,在有症状的椎骨上进行经皮椎体成形术可以立即机械地支持脊柱单元的稳定性,并在复位后保持椎骨的形状。
结论:经皮骨水泥增强短节段椎弓根螺钉内固定联合经皮椎体成形术是治疗无神经系统症状的III期Kummell病的有效方法。能有效恢复椎体高度,矫正后凸畸形,改善椎管狭窄,并取得满意的短期临床疗效。