[1]胡勇,赖欧杰.Kmmell病的发生机制、影像学表现及治疗[J].中医正骨,2018,30(06):1-3.
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Kümmell病的发生机制、影像学表现及治疗()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年06期
页码:
1-3
栏目:
专家述评
出版日期:
2018-06-20

文章信息/Info

作者:
胡勇赖欧杰
浙江省宁波市第六医院,浙江 宁波 315040
关键词:
脊柱骨折mmell病 述评
文献标志码:
A
摘要:
Kümmell病主要表现为迟发性椎体塌陷及其所致的脊柱后凸畸形和神经功能损害。该病的发生机制目前尚无定论,可能是椎体缺血坏死、骨折后椎体内假关节形成等多个因素相互作用、相互影响所致。目前还没有针对该病影像学诊断的金标准,但X线、CT提示的椎体塌陷、椎体内真空裂隙形成及MRI中的双线征可作为影像学诊断的依据。对于椎体后壁完整、无严重脊柱后凸畸形及神经功能损害的Ⅰ、Ⅱ期Kümmell病,采用经皮椎体成形术或经皮椎体后凸成形术治疗能够取得良好的疗效; 对于Ⅲ期Kümmell病,选择开放性手术治疗更为恰当,但术式的选择须综合考虑术者的经验、脊柱后凸畸形程度及神经功能损害程度等多方面因素。

参考文献/References:

[1] ZHANG X,HU W,YU J,et al.An effective treatment option for kümmell disease with neurological deficits:modified transpedicular subtraction and disc osteotomy combined with Long-Segment fixation[J].Spine(Phila Pa 1976),2016,41(15):923-930. [2] FREEDMAN BA,HELLER JG.Kummel disease:a not-so-rare complication of osteoporotic vertebral compression fractures[J].J Am Board Fam Med,2009,22(1):75-78. [3] D'ORIA S,DELVECCHIO C,DIBENEDETTO M,et al.Case report of Kummell's disease with delayed onset myelopathy and the literature review[J].Eur J Orthop Surg Traumatol,2018,28(2):309-316. [4] 滕冲,陈维善,李浩,等.Kummell病发病机制及影像学表现[J].国际骨科学杂志,2012,33(1):55-56. [5] MATZAROGLOU C,GEORGIOU CS,ASSIMAKOPOULOS K,et al.Kümmell's disease:pathophysiology,diagnosis,treatment and the role of nuclear medicine.Rationale according to our experience[J].Hell J Nucl Med,2011,14(3):291-299. [6] HE D,YU W,CHEN Z,et al.Pathogenesis of the intravertebral vacuum of Kümmell's disease[J].Exp Ther Med,2016,12(2):879-882. [7] RANJAN M,MAHADEVAN A,PRASAD C,et al.Kümmell's disease - uncommon or underreported disease:A clinicopathological account of a case and review of literature[J].J Neurosci Rural Pract,2013,4(4):439-442. [8] KIM DY,LEE SH,JANG JS,et al.Intravertebral vacuum phenomenon in osteoporotic compression fracture:report of 67 cases with quantitative evaluation of intravertebral instability[J].J Neurosurg,2004,100(1 Suppl Spine):24-31. [9] 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. [10] HASEGAWA K,HOMMA T,UCHIYAMA S,et al.Vertebral pseudarthrosis in the osteoporotic spine[J].Spine(Phila Pa 1976),1998,23(20):2201-2206. [11] MIROVSKY Y,ANEKSTEIN Y,SHALMON E,et al.Vacuum clefts of the vertebral bodies[J].AJNR Am J Neuroradiol,2005,26(7):1634-1640. [12] YU CW,HSU CY,SHIH TT,et al.Vertebral osteonecrosis:Mr imaging findings and related changes on adjacent levels[J].AJNR Am J Neuroradiol,2007,28(1):42-47. [13] ZHANG GQ,GAO YZ,ZHENG J,et al.Posterior decompression and short segmental pedicle screw fixation combined with vertebroplasty for Kümmell's disease with neurological deficits[J].Exp Ther Med,2013,5(2):517-522. [14] 伍成东,谢胜荣,卢小刚,等.Kummell病的影像学研究进展[J].中华临床医师杂志(电子版),2014,8(24):4489-4491. [15] LIBICHER M,APPELT A,BERGER I,et al.The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures:results from a radiological and histological study[J].Eur Radiol,2007,17(9):2248-2252. [16] LI H,LIANG CZ,CHEN QX.Kümmell's disease,an uncommon and complicated spinal disorder: a review[J].J Int Med Res,2012,40(2):406-414. [17] LI KC,WONG TU,KUNG FC,et al.Staging of kümmell's disease[J].J Musculoskelet Res,2004,8(1):43-55. [18] SUN K,LIU Y,PENG H,et al.A comparative study of high-viscosity cement percutaneous vertebroplasty vs.low-viscosity cement percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures[J].J Huazhong Univ Sci Technology Med Sci,2016,36(3):389-394. [19] CHEN L,DONG R,GU Y,et al.Comparison between Balloon Kyphoplasty and Short Segmental Fixation Combined with Vertebroplasty in the Treatment of Kümmell's Disease[J].Pain Physician,2015,18(4):373-381. [20] PARK JW,PARK JH,JEON HJ,et al.Kümmell's disease treated with percutaneous vertebroplasty:minimum 1 year follow-up[J].Korean J Neurotrauma,2017,13(2):119-123. [21] WANG HS,KIM HS,JU CI,et al.Delayed bone cement displacement following balloon kyphoplasty[J].J Korean Neurosurg Soc,2008,43(4):212-214. [22] YU W,LIANG,JIANG X,et al.Efficacy and safety of the target puncture technique for treatment of osteoporotic vertebral compression fractures with intravertebral clefts[J].J Neurointerv Surg,2017,9(11):1113-1117. [23] FENG WANG,DACHUAN WANG,BINGYI TAN,et al.Comparative Study of Modified Posterior Operation to Treat Kümmell's Disease[J].Medicine(Baltimore),2015,94(39):1595. [24] KANAYAMA M,ISHIDA T,HASHIMOTO TA,et al.Role of major spine surgery using kaneda anterior instrumentation for osteoporotic vertebral collapse[J].J Spinal Disord Tech,2010,23(1):53-56. [25] LEE SH,KIM ES,EOH W.Cement augmented anterior Reconstruction with short posterior instrumentation:a less invasive surgical option for Kummell's disease with cord compression[J].J Clin Neurosci,2011,18(4):509-514. [26] SUDO H,ITO M,ABUMI K,et al.One-stage posterior instrumentation surgery for the treatment of osteoporotic vertebral collapse with neurological deficits[J].Eur Spine J,2010,19(6):907-915.

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更新日期/Last Update: 2018-10-30