摘要
目的探讨混合现实技术(MR)辅助经皮椎体后凸成形术(PKP)在老年胸腰椎Kümmell病中的应用价值。方法将2016年10月-2017年4月拟行PKP且符合入选标准的34例老年胸腰椎Kümmell病患者纳入研究,根据随机数字表法分为2组:对照组(即A组,传统C臂透视组)和试验组(即B组,MR技术辅助导航组),每组17例。记录手术时间、骨水泥注入量,以及术前、术后1周、末次随访时后凸Cobb角、椎体前缘压缩比、腰背痛视觉模拟评分(VAS)、运动功能Oswestry功能障碍指数(ODI),并观察术后骨水泥渗漏情况。结果所有患者均获随访,随访时间为12~24个月,平均时间为(22.4±0.0)个月。2组骨水泥注入量差异有统计学意义(P<0.01)。与术前相比,2组术后1周及末次随访Cobb角、椎体前缘压缩比差异均有统计学意义(P<0.05)。2组术后1周及末次随访Cobb角、椎体前缘压缩比,B组优于A组,但差异无统计学意义(P0.05)。2组VAS评分、ODI评分术后较术前均有明显改善(P<0.05),但B组改善更显著。随访中B组无骨水泥渗漏,A组有4例患者出现骨水泥渗漏。结论 MR技术和PKP的有机结合可以达到精准穿刺及对病变区的准确定位,可能是老年Kümmell病微创个性化治疗的有效方法。
Objective To explore the clinical application value of percutaneous kyphoplasty(PKP) assisted with mixed reality(MR) technology in the treatment of Kümmell’s disease in the elderly.Methods 34 elderly with Kümmell’s disease to undergo PKP assisted with MR technology during the period from October,2016 to April,2017 were randomly divided into 2 groups:group A(control group) and group B(observation group),17 in each;PKP assisted with traditional C-arm fluoroscopy was made to cases in group A while PKP assisted with MR technology to those in group B;the time length of operation,volume of bone cement injection,the Cobb angles and vertebral anterior compression ratios at the time point of before treatment(T1),1 week after treatment(T2) and the latest follow-up(T3),the visual analogue scale(VAS) scores and Oswestry dysfunction index(ODI) of all the cases were recorded and the cement leakage after treatment was observed.Results Follow-up was made to all the cases in the 2 group and last from 12 to 24 months with the average of 22.4 months;there was a statistical difference in bone cement injection volume between the 2 groups(P<0.01);the differences among the Cobb Angles and the vertebral anterior compression ratios at t1,t2,t3 were statistically significant(P<0.05);the Cobb Angles and the vertebral anterior compression ratios of the cases in group A were better improved than those in group B at T2 and T3 while with differences of no statistical significance(P<0.05);after treatment,the VAS and ODI scores of the cases in both groups decreased significantly(P<0.05) while the decrease in group B was obviously greater;follow-up showed that no leakage of bone cement was found in group B but in 4 cases in group A.Conclusions PKP assisted with MR technology can lead to accurate puncture and precise location of the lesions,and it might be an effective and individualized minimally invasive treatment of Kümmell’s disease in the elderly.
作者
严俊伟
徐燕
张惠康
王敏成
王黎明
梁斌
Yan Junwei;Xu Yan;Zhang Huikang;Wang Mincheng;Wang Liming;Liang Bin(Department of Orthopaedics,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu Province,210006;Jinse Medical Information Technology(Changzhou)Co.,Ltd.,Changzhou City,Jiangsu Province 213100,P.R.China)
出处
《老年医学与保健》
CAS
2019年第6期719-722,共4页
Geriatrics & Health Care
基金
南京市医学重点科技发展项目(ZKX15024)
关键词
老年
Kümmell病
经皮后凸成形术
混合现实
精准医疗
elderly
Kümmell’s disease
percutaneous kyphoplasty(PKP)
mixed reality(MR) technology
precision medicine
