Vertebroplasty for the Treatment of Traumatic Nonosteoporotic Compression Fractures
Vertebroplasty for the Treatment of Traumatic Nonosteoporotic Compression Fractures
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DOI：
10.3174/ajnr.a1356
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发表时间：
2009-02-01
影响因子：
3.5
通讯作者：
Kallmes, D. F.
中科院分区：
文献类型：
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作者：
Knavel, E. M.;Thielen, K. R.;Kallmes, D. F.
背景和目的：椎体成形术常用于骨质疏松性和肿瘤性压缩性骨折，但很少有证据表明其用于创伤性非骨质疏松性压缩性骨折。本研究的目的是评估经皮椎体成形术治疗外伤性非骨质疏松性压缩性骨折的安全性和有效性。材料和方法：我们对接受经皮椎体成形术的819例患者（982例手术）进行了回顾性研究，以确定骨密度测量评分正常或先前未诊断为骨质疏松症、多发性骨髓瘤或长期使用类固醇史的患者。随访评估包括休息和活动时的疼痛（用视觉模拟量表[VAS]评估）、药物使用和活动能力。同时收集Roland-Morris残疾问卷（RDQ）得分。统计分析采用双尾t检验比较术后结果与基线值。结果：纳入15例患者（53%为女性）。平均年龄为60岁，t-score为-0.35。我们发现，从2小时随访开始，VAS评分（休息和活动时）和RDQ评分均有显著改善。此外，我们发现药物使用明显减少，活动能力明显改善。并发症发生率低，以无症状的水泥外渗为特征。结论：从我们的研究中，我们已经表明椎体成形术可以成功和安全地用于创伤性非骨质疏松性压缩性骨折患者。这些患者在保守治疗失败后应采用椎体成形术，并可用于替代更具侵入性的脊柱重建技术。
BACKGROUND AND PURPOSE: Vertebroplasty is commonly used for osteoporotic and neoplastic compression fractures, yet little evidence exists for its use in traumatic nonosteoporotic compression fractures. The purpose of this study was to evaluate the safety and efficacy of percutaneous vertebroplasty for patients with traumatic nonosteoporotic compression fractures.MATERIALS AND METHODS: We performed a retrospective review of 819 patients (982 procedures) who underwent percutaneous vertebroplasty, to identify patients who had normal bone mineral densitometry scores or had no previous diagnosis of osteoporosis, multiple myeloma, or history of long-term steroid use. Follow-up evaluations included pain at rest and with activity (assessed with the visual analog scale [VAS]), medication use, and mobility. Roland-Morris Disability Questionnaire (RDQ) scores were also collected. Statistical analysis included a 2-tailed t test comparing postprocedure outcomes with baseline values.RESULTS: Fifteen patients (53% women) were included. Mean age and t-score were 60 years and -0.35, respectively. We found significant improvements in the VAS scores, both at rest and with activity, and in the RDQ scores, starting at the 2-hour follow-up. Additionally, we found marked decreases in medication use and improvements in mobility. The complication rate was low and characterized by asymptomatic extravasation of cement.CONCLUSIONS: From our study, we have shown that vertebroplasty can be successfully and safely used in patients with traumatic nonosteoporotic compression fractures. Vertebroplasty in these patients should be used after failure of conservative treatments and may be used in place of more invasive spinal reconstruction techniques.