Unipedicular Balloon Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fractures: Early Results
Unipedicular Balloon Kyphoplasty for the Treatment of Osteoporotic Vertebral Compression Fractures: Early Results
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DOI：
10.1097/bsd.0b013e31815d6997
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发表时间：
2008-12-01
影响因子：
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通讯作者：
Lane, Joseph M.
中科院分区：
文献类型：
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作者：
Papadopoulos, Elias C.;Edobor-Osula, Folorunsho;Lane, Joseph M.
前言：传统的双椎弓根后凸成形术被证明是治疗骨质疏松性椎体压缩骨折所致疼痛的安全有效的方法。然而，单侧脊柱后凸成形术因其理论上的速度快、安全、费用低而成为传统的双椎弓根后凸成形术的一种有吸引力的替代方法；到目前为止，生物力学测试表明实验性单侧脊柱后凸成形术具有与双椎弓根后凸成形术相当的性能。到目前为止，还没有关于单侧气囊后凸成形术的有效性和安全性的临床数据。方法：采用单侧球囊后凸成形术对14 2例骨质疏松性VCFs患者进行317例脊柱后凸成形术。这项技术包括单侧椎体中心插管和放置单个气囊夯实。评估疼痛和身体功能的改善情况。分别于术前、术后3个月和12个月进行视觉模拟评分(VAS)、SF-36评分和OSwestry功能障碍指数(ODI)评分。记录与手术相关的并发症和骨水泥外渗率。结果：术后3个月VAS、SF-36评分和ODI均有显著改善，完成SF-36问卷的30例患者在12个月的随访中保留了这些结果(仅有19例患者VAS/ODI评分持续改善)。无并发症发生，骨水泥渗出34例(10.73%)均无症状。平均中等高度恢复率为48.9%，将治疗椎体分为高度恢复组和无高度恢复组(分别占90.1%和9.9%)，矫正平均中等高度恢复率为54%。结论：单椎弓根(单侧)椎弓根外后凸成形术是治疗骨质疏松性VCFs疼痛的一种安全有效的方法。作为一种技术，它更快、更便宜，而且对手术室人员来说涉及的辐射暴露更少。
Introduction: The traditional bipedicular kyphoplasty was proved to be safe and effective for the treatment of pain associated with osteoporotic vertebral compression fractures (VCFs). Nevertheless, unilateral kyphoplasty would be an attractive alternative to the traditional bipedicular kyphoplasty owing to theoretical speed, safety, and less expense; thus far, the biomechanical testing showed that experimental unilateral kyphoplasty had properties comparable with bipedicular kyphoplasty. To date, no clinical data are available regarding the efficacy and safety of unilateral balloon kyphoplasty. In this prospective observational study, the clinical and radiographic outcomes of the unipedicular (unilateral) balloon kyphoplasty in osteoporotic VCFs are evaluated.Methods: Three hundred and seventeen kyphoplasty procedures were performed in 142 patients with osteoporotic VCFs using the unilateral technique. This technique involves the unilateral cannulation of the center of the vertebral body and the placement of a single balloon tamp. To evaluate improvement in pain and physical function.. preoperative and postoperative scores of visual analog scale (VAS), SF-36, and Oswestry Disability Index (ODI) were compared at 3 and 12 months postoperatively. Complications related to the procedure and cement extravasation rates were recorded. Height restoration and overall coronal and sagittal spinal alignment were assessed preoperatively and postoperatively.Results: Significant improvement on the VAS, SF-36 scores, and ODI was noted at 3 months postoperatively; these results were preserved at the 12-month follow-up for the 30 patients who completed the SF-36 questionnaire (VAS/ODI scores were available only for 19 of the 30 patients also Showing Sustained improvement). No complication was recorded; 34 cases (10.73%) of cement extravasation were all asymptomatic. Mean middle height restoration was found 48.9%; when vertebral levels treated were stratified into 2 groups, with or without height restoration (90.1% and 9.9% of all levels, respectively), corrected mean middle height restoration was found 54%. No lateral wedging or changes in the coronal alignment was observed in the unipedicular group.Conclusions: Unipedicular (unilateral) extrapedicular kyphoplasty is both a safe and efficacious alternative to the traditional bipedicular kyphoplasty for the treatment of painful osteoporotic VCFs. As a technique, it is faster, less expensive, and involves less radiation exposure for the surgical suite personnel.