Dudeney S, Lieberman I H, Reinhardt M-K, Hussein M
Department of Orthopaedics and Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
J Clin Oncol. 2002 May 1;20(9):2382-7. doi: 10.1200/JCO.2002.09.097.
We prospectively evaluated the safety and efficacy of kyphoplasty in the treatment of osteolytic vertebral compression fractures resulting from multiple myeloma. The principle symptoms in multiple myeloma result from bone destruction, especially the spine. Kyphoplasty is a new technique that involves the introduction of inflatable bone tamps (IBT) into the vertebral body. The purpose of the IBT is to restore the vertebral body back toward its original height, while creating a cavity that can be filled with highly viscous bone cement.
Fifty-five consecutive kyphoplasty procedures were performed in 18 patients with osteolytic vertebral compression fractures resulting from multiple myeloma. Cement leakage and any complications were recorded. Early objective analysis was made by comparing preoperative and latest Short Form 36 Health Survey scores. Height restoration was estimated by measuring vertebral height on lateral radiographs.
The mean age of patients was 63.5 years, mean duration of symptoms was 11 months, and mean follow-up was 7.4 months. There were no major complications related directly to use of this technique. On average, 34% of height lost at the time of fracture was restored. Asymptomatic cement leakage occurred at two (4%) of 55 levels. Significant improvement in SF36 scores occurred for Bodily Pain (23.2 to 55.4, P =.0008), Physical Function (21.3 to 50.6, P =.0010), Vitality (31.3 to 47.5, P =.010), and Social Functioning (40.6 to 64.8, P =.014).
Kyphoplasty was efficacious in the treatment of osteolytic vertebral compression fractures resulting from multiple myeloma. Kyphoplasty is associated with early clinical improvement of pain and function as well as some restoration of vertebral body height.
我们前瞻性评估了椎体后凸成形术治疗多发性骨髓瘤所致溶骨性椎体压缩骨折的安全性和有效性。多发性骨髓瘤的主要症状源于骨质破坏，尤其是脊柱。椎体后凸成形术是一种新技术，包括将可膨胀骨填充器（IBT）置入椎体。IBT的目的是使椎体恢复至原始高度，同时形成一个可填充高粘性骨水泥的腔隙。
对18例多发性骨髓瘤所致溶骨性椎体压缩骨折患者连续实施了55次椎体后凸成形术。记录骨水泥渗漏情况及任何并发症。通过比较术前和最新的简明健康调查问卷（Short Form 36 Health Survey）评分进行早期客观分析。通过测量侧位X线片上的椎体高度评估椎体高度恢复情况。
患者的平均年龄为63.5岁，平均症状持续时间为11个月，平均随访时间为7.4个月。没有直接与该技术使用相关的严重并发症。骨折时丢失的高度平均恢复了34%。55个椎体节段中有2个（4%）发生了无症状性骨水泥渗漏。简明健康调查问卷（SF36）评分在身体疼痛（从23.2至55.4，P = 0.0008）、生理功能（从21.3至50.6，P = 0.0010）、活力（从31.3至47.5，P = 0.010）和社会功能（从40.6至64.8，P = 0.014）方面有显著改善。
椎体后凸成形术治疗多发性骨髓瘤所致溶骨性椎体压缩骨折有效。椎体后凸成形术可使疼痛和功能早期得到临床改善，并使椎体高度得到一定程度恢复。
