Differences in short-term clinical and radiological outcomes depending on timing of balloon kyphoplasty for painful osteoporotic vertebral fracture
Differences in short-term clinical and radiological outcomes depending on timing of balloon kyphoplasty for painful osteoporotic vertebral fracture
复制标题
DOI：
10.1016/j.jos.2017.09.019
复制
发表时间：
2018-01-01
影响因子：
1.7
通讯作者：
Nakamura, Hiroaki
中科院分区：
文献类型：
--
作者：
Takahashi, Shinji;Hoshino, Masatoshi;Nakamura, Hiroaki
背景资料：球囊椎体后凸成形术或椎体成形术被广泛用作骨质疏松性椎体骨折（OVF）的手术干预，其效果已在许多既往研究中进行了研究。然而，尚未正式研究手术时机对患者结局的影响。本研究的目的是探讨根据球囊椎体后凸成形术的时机，OVF的手术结果的差异。方法：这是一项多中心队列研究。参与者包括2012年1月至2016年1月期间接受球囊椎体后凸成形术的72名连续患者。根据发病后椎体后凸成形术的时间将患者分为两组进行分析（早期组：2个月）。结果：72例患者均获得有效分析。其中，27例（38%）患者在症状发作后2个月内接受了椎体后凸成形术。晚期组在术前显示骨折椎体的角度运动更大（p = 0.005）和椎体前部高度压缩（p = 0.001）。根据年龄和术前结局调整的最终结局显示，早期组的腰痛视觉模拟量表（VAS）评分低于晚期组（19.9 vs. 30.4，p = 0.049）。早期组的最终相对椎体前高度和后凸角比晚期组更好地保留（分别为p = 0.002和p = 0.020），尽管绝对差异不显著。在发病后2个月内接受椎体后凸成形术的患者中，球囊椎体后凸成形术前后的椎体高度和后凸角较大，最终随访时腰痛的VAS评分更好。我们的结果支持在2个月内进行椎体后凸成形术。(C)2017年日本骨科协会。Elsevier B.V.出版，保留所有权利。
Background: Balloon kyphoplasty or vertebroplasty is widely performed as a surgical intervention for osteoporotic vertebral fracture (OVF) and the effects have been investigated in many previous studies. However, the influence of the timing of the procedure on patient outcomes has not been studied formally. The purpose of this study was to investigate differences in the surgical outcomes of OVFs according to the timing of balloon kyphoplasty.Methods: This was a multicenter cohort study. Participants comprised 72 consecutive patients who underwent balloon kyphoplasty between January 2012 and January 2016. Patients were analyzed in two groups according to the timing of kyphoplasty after onset (Early group: 2 months). Follow-up continued for more than 6 months.Results: A total of 72 patients were effectively analyzed. Of these, 27 (38%) patients underwent kyphoplasty within 2 months after symptom onset. The Late group showed greater angular motion of fractured vertebrae (p = 0.005) and compression of anterior vertebral height (p = 0.001) before surgery. Final outcomes adjusted for age and preoperative outcome showed lower visual analog scale (VAS) scores for low back pain in the Early group than in the Late group (19.9 vs. 30.4, p = 0.049). Final relative anterior vertebral height and kyphotic angle were more preserved in the Early group than in the Late group (p = 0.002 and p = 0.020, respectively), although absolute differences were not significant.Conclusions: Vertebral height and kyphotic angle before and after balloon kyphoplasty were greater in patients who underwent kyphoplasty within 2 months after onset, and the VAS score for low back pain at final follow-up was better. Our results support kyphoplasty within 2 months. (C) 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.