Kyphoplasty treatment of vertebral fractures: 2-Year outcomes show sustained benefits
Kyphoplasty treatment of vertebral fractures: 2-Year outcomes show sustained benefits
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DOI：
10.1097/01.brs.0000192687.07392.f1
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发表时间：
2006-01-01
期刊：
影响因子：
3
通讯作者：
Renfro, MB
中科院分区：
文献类型：
--
作者：
Ledlie, JT;Renfro, MB
研究设计。回顾性单中心连续病例系列，随访2年。检查接受后凸成形术的患者的长期临床和放射学影响，包括椎体形状的改变。背景资料摘要。后凸成形术是一种微创复位和稳定椎体骨折的方法，如我们之前发表的1年预后报告（J neurosurgery; 2003; 98: 36-42）所述，可以缓解疼痛并改善身体功能。到2001年12月，对所有117例（151例骨折）患者的安全性（并发症和水泥外渗）进行了监测。对其中65例患者进行了至少2年的随访，比较了术前和术后视觉模拟量表疼痛评分、镇痛使用和活动状态。术前、术后和随访2年后评估该队列的前、中线、后椎体高度和高度比。后凸成形术后疼痛评分、患者独立无困难行走能力和处方止痛药需求显著改善（P < 0.001），并在术后2年保持不变或改善。术后各时间间隔椎体高度均显著增高（P < 0.003）， 90%骨折椎体高度增高>= 10%。治疗后骨折的形态高度比也显著增加（P < 0.001）： 0.67 +/- 0.24至0.79 +/- 0.17,0.63 +/- 0.16至0.83 +/- 0.11。11.3%的骨折发生无症状水泥外渗，在随访期间，在未治疗的水平上以每年4.5%的速度发生额外骨折。术后无后凸成形术相关并发症。后凸成形术可显著改善疼痛和功能，并显著恢复椎体高度和形态指标的正常化，并在治疗后至少2年内保持稳定。
Study Design. Retrospective single-center consecutive case series with 2-year follow-up.Objectives. To examine patients who underwent kyphoplasty for long-lasting clinical and radiologic effects, including changes in vertebral body shape.Summary of Background Data. Kyphoplasty is the minimally invasive reduction and stabilization of vertebral body fractures, resulting in pain relief and improved physical function as described in our previously published 1-year outcomes report (J Neurosurg 2003; 98: 36-42).Methods. Safety ( complications and cement extravasation) was monitored in all 117 patients ( 151 fractures) treated through December 2001. Preoperative and postoperative visual analog scale pain scores, analgesia usage, and ambulatory status were compared in 65 of these patients with at least a 2-year follow-up. Anterior, midline, posterior vertebral body heights, and height ratios from this cohort were assessed before surgery, immediately postoperatively, and after 2 years of follow-up.Results. Pain scores, patient ability to ambulate independently and without difficulty, and need for prescription pain medications improved significantly (P < 0.001) after kyphoplasty, and remained unchanged or improved at 2 years postoperatively. Vertebral heights significantly (P < 0.003) increased at all postoperative intervals, with >= 10% height increases in 90% of fractures. Morphometric height ratios for treated fractures also significantly increased (P < 0.001): 0.67 +/- 0.24 to 0.79 +/- 0.17 and 0.63 +/- 0.16 to 0.83 +/- 0.11. Asymptomatic cement extravasation occurred in 11.3% of fractures, and during the follow-up, additional fractures occurred in previously untreated levels at a rate of 4.5% per year. There were no kyphoplasty related complications.Conclusions. Kyphoplasty markedly improves pain and function, and results in significant vertebral height restoration and normalization of morphologic shape indexes that remain stable for at least 2 years following treatment.