Kyphoplasty for the treatment of incomplete osteoporotic burst fractures
Kyphoplasty for the treatment of incomplete osteoporotic burst fractures
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DOI：
10.1007/s00586-010-1281-5
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发表时间：
2010-06-01
影响因子：
2.8
通讯作者：
Ruchholtz, Steffen
中科院分区：
文献类型：
--
作者：
Krueger, Antonio;Zettl, Ralph;Ruchholtz, Steffen
椎体后凸成形术已成为治疗疼痛性骨质疏松性压缩骨折的标准手术。根据目前的指南，椎体后壁受累是相对禁忌症。从2002年2月到2008年1月，97名至少有一次AO分类A 3.1骨折的患者接受了椎体后凸成形术治疗。对患者结果的中期评估进行了结构化的随访。 97 名平均年龄为 76.1 +/- A 12.36 (59-98) 岁的椎体后缘受累患者（其中 68 名女性，29 名男性）接受了椎体后凸成形术治疗。 75名患者因低处坠落导致骨折，5名患者遭遇交通事故，17名患者不记得有任何外伤类型。根据 AO 分级，A 3.1.1 损伤 109 例，A3.1.3 损伤 1 例。手术前，所有患者均进行神经学检查，无病理发现。 79 例骨折伴有椎管狭窄[平均为 15% (10-40)]。总体而言，134 块椎骨接受了球囊椎体后凸成形术（81 x 1 节段、22 x 2 节段、3 x 3 节段）。 47.4%的患者术后出现骨水泥渗漏。然而，所有出现骨水泥外渗的患者在临床上均无异常。使用视觉模拟量表，患者表示手术前疼痛平均为 8.1，而手术后疼痛显着下降，平均为 1.6 (p < 0.001)。对于骨质疏松性椎体骨折并部分包含椎体后壁的老年患者，椎体后凸成形术是一种有效的手术，并发症很少。
Kyphoplasty has become a standard procedure in the treatment of painful osteoporotic compression fractures. According to current guidelines, involvement of the posterior wall of the vertebral body is a relative contraindication. From February 2002 until January 2008, 97 patients with at least one AO classification A 3.1 fracture were treated by kyphoplasty. There was a structured follow-up for the medium-term evaluation of the patients' outcome. Ninety-seven patients (68 of whom were females and 29 of whom were males) with involvement of the vertebra's posterior margin averaging 76.1 +/- A 12.36 (59-98) years were treated by kyphoplasty. The fractures of 75 patients were caused by falls from little height, 5 patients had suffered traffic accidents and in the case of 17 patients, no type of trauma was remembered. According to the AO classification, there were 109 A 3.1.1 and one A3.1.3 injuries. Prior to surgery, all patients were neurologically without pathological findings. Seventy-nine fractures were accompanied by a narrowing of the spinal canal [average of 15% (10-40)]. Overall, 134 vertebras were treated by Balloon kyphoplasty (81 x 1 segment, 22 x 2 segments, 3 x 3 segments). In 47.4% of the patients, cement leakage was observed after surgery. All patients with cement extravasation, however, were clinically unremarkable. Using the visual analog scale, patients stated that prior to surgery their pain averaged 8.1, whereas after surgery it significantly decreased and averaged 1.6 (p < 0.001). In geriatric patients with osteoporotic vertebral fractures with partial inclusion of the posterior wall of the vertebral body, kyphoplasty is an effective procedure with few complications.