Comparison of kyphoplasty with use of a calcium phosphate cement and non-operative therapy in patients with traumatic non-osteoporotic vertebral fractures
Comparison of kyphoplasty with use of a calcium phosphate cement and non-operative therapy in patients with traumatic non-osteoporotic vertebral fractures
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DOI：
10.1007/s00586-008-0880-x
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发表时间：
2009-05-01
影响因子：
2.8
通讯作者：
DaFonseca, K.
中科院分区：
文献类型：
--
作者：
Schmelzer-Schmied, Nicole;Cartens, C.;DaFonseca, K.
目前，对于年轻的稳定性创伤性椎体骨折患者的标准治疗选择之一是使用支具进行保守治疗。椎体后凸成形术作为一种微创手术，已被证明可有效稳定椎体骨折，从而立即缓解疼痛并改善身体功能。这项前瞻性研究的目的是澄清急性创伤性椎体骨折患者是从椎体后凸成形术还是从支架保守治疗中获益更多。在两个中心进行了前瞻性研究。研究纳入了40例A1-A3型急性疼痛性创伤性椎体骨折（AO分类）患者，这些患者在充分创伤后，无骨质疏松症，适用于椎体后凸成形术或支具治疗。随访12个月。与保守治疗组相比，椎体后凸成形术组的患者在术后立即表现出有益且显着的效果，并且在术后1个月和3个月的疼痛感、活动度和椎体高度方面表现出更好的结果。12个月后，除椎体高度外，两组间差异无显著性。椎体后凸成形术可早期和持久地减轻疼痛并改善日常活动。然而，临床上无症状的骨水泥泄漏高达45%，我们不知道其长期后果。必须告知每一位接受椎体后凸成形术治疗的创伤性椎体骨折患者这一点。长期的结果是突出的，我们的研究结果需要通过随机对照试验证实。
One of the current standard treatment options for younger patients with stable traumatic vertebral fractures is conservative treatment using braces. Kyphoplasty as a minimally invasive procedure has been shown to be effective in stabilizing vertebral body fractures, resulting in immediate pain relief and improved physical function. The purpose of this prospective study was to clarify whether patients with acute traumatic vertebral fractures benefit more from kyphoplasty or from conservative treatment with a brace. A prospective study was undertaken in two centers. Forty patients with acute painful traumatic vertebral body fractures type A1-A3 (AO-classification) after adequate trauma, without osteoporosis, suitable for kyphoplasty or therapy by brace were included into the study. Follow-up was 12 months. Patients of the kyphoplasty group showed an immediate beneficial and significant effect postoperatively, and better outcomes 1 and 3 months after operation compared to the conservatively treated group in pain feeling, mobility and vertebral body height. After 12 months the difference between both groups was not significant excepting the vertebral body height. Kyphoplasty provides early and lasting reduction of pain and improvement of daily activity. However, there are clinically asymptomatic cement leakages in up to 45% of which we do not know the consequences in long term. Every patient with traumatic vertebral body fracture treated by kyphoplasty has to be informed about that. Long-time results are outstanding and our findings require confirmation by randomized controlled trials.