Kiimmell病研究新进展.docVIP

Kiimmell病研究新进展 　　[摘要]Kümmell病为发病机制与诊断均尚不明确的少见病，其主要特点为有轻微外伤导致的脊柱疼痛，经历数月或数年长短不一的无症状期后相同部位疼痛再次复发、加重，并进展为脊柱后凸畸形。此病早期因技术不足、设备不完善，未引起临床重视，导致骨科一直对于该病没有充分认识，造成Kümmell病的漏诊与误诊。随着德国Kümmell对该病率先报道，并且随着近年来X线、CT及MR等影像学技术的飞速发展，关于Kümmell病的报道与研究趋于增多，为提高对Kümmell病的认识，结合临床体会，现对Kümmell病的相关研究作一综述。 　　[关键词]Kümmell病；骨质疏松症；真空裂隙征；椎体成形术 　　[中图分类号] R683.2 [文献标识码] A [文章编号] 1674-4721（2017）11（a）-0012-05 　　Recent advances in research of Kümmell′s disease 　　WANG Shao-qian NIU Lei▲ WANG Hui 　　Department of Orthopedics，Hefei Second People′s Hospital，Anhui Province，Hefei 230011，China 　　[Abstract]Kümmell′s disease is a rare disease with unclear pathogenesis and diagnosis and its main characteristics is a minor trauma of spinal pain，which may recur，aggravate and progress to kyphosis in the same area after months or years of different lengths of the asymptomatic period.Because of the lack of technology and equipment，the disease has not been paid much attention to in the early stage.Department of orthopedics has not been fully aware of the disease，resulting in missed diagnosis and misdiagnosis of Kümmell′s disease.With the first report of the disease by Kümmell，a German，as well as rapid development of technology，CT，MR，and X-ray imaging studies in recent years，reports and researches on Kümmell′s disease tends to increase.In order to improve the understanding of Kümmell′s disease，this paper make a review of the related research of Kümmell′s disease in combination with clinical experience. 　　[Key words]Kümmell′s disease；Osteoporosis；Vacuum fracture sign；Vertebroplasty 　　Kümmell首次被?t学界所认识，是经德国外科医生Herman Kümmell[1]首先报道，他报道了长期随访的6例迟发性胸腰椎压缩性骨折病例。后来研究此病的学者将其称为Kümmell病，学者们将创伤后椎体迟发性骨坏死、骨质疏松性椎体压缩性骨折不愈合病、椎体内真空裂隙、椎体内假关节和迟发性椎体塌陷也称为Kümmell病[2]。该病的主要临床表现为腰背疼痛较之前明显加重，以翻身、起床、站立及行走活动时尤甚[3]，并继而发展成椎体塌陷，进一步进展为脊柱后凸畸形[4]。近年来随着社会老龄化，Kümmell病的研究报道逐渐增多，本文对Kümmell病的相关研究作一综述，现报道如下。 　　1发病机制 　　目前关于Kümmell病的发病机制尚不明确，该病的高危因素包括高血压病、糖尿病、酗酒、感染性疾病、长期服用糖皮质激素及代谢性疾病等，许多学者从不同角度提出不同假说来阐述该病的的发病机制，归纳总结，可分以下几种。 　　1.1椎体缺血性骨坏死 　　Steel等[5]于