Phillips Frank M, Pfeifer Bernard A, Lieberman Isador H, Kerr Eubulus J, Choi In Sup, Pazianos Artemis G
University of Chicago Spine Center, Chicago, Illinois, USA.
Instr Course Lect. 2003;52:559-67.
Although nonsurgical treatment of osteoporotic vertebral compression fractures, including medication, exercise, bracing, and bed rest, have been reasonably effective, vertebroplasty and kyphoplasty have evolved as valuable adjunctive treatment options. Over the past decade, vertebroplasty, which involves the percutaneous injection of bone cement directly into the fractured vertebral body, has been used as a treatment for painful osteoporotic vertebral body compression fractures, a leading cause of morbidity in the elderly. Kyphoplasty, another minimally invasive procedure that allows for correction of spinal deformity and for controlled cement filling of the fractured vertebral body, involves the percutaneous cannulation of the vertebral body followed by the placement of an inflatable bone tamp. Reported results for both vertebroplasty and kyphoplasty suggest rapid improvement in pain and physical functioning in patients with osteoporotic vertebral compression fractures. Kyphoplasty allows for low-pressure cement injection and affords the opportunity to correct spinal deformity. Further study is required to define the precise indications, timing, and relative merits of these techniques.
尽管骨质疏松性椎体压缩骨折的非手术治疗，包括药物治疗、运动、支具固定和卧床休息，已取得了一定成效，但椎体成形术和后凸成形术已发展成为有价值的辅助治疗选择。在过去十年中，椎体成形术，即将骨水泥经皮直接注入骨折椎体，已被用于治疗疼痛性骨质疏松性椎体压缩骨折，这是老年人发病的主要原因。后凸成形术是另一种微创手术，可矫正脊柱畸形并控制骨折椎体的骨水泥填充，该手术包括经皮穿刺椎体，随后放置可膨胀的骨扩张器。椎体成形术和后凸成形术的报告结果表明，骨质疏松性椎体压缩骨折患者的疼痛和身体功能迅速改善。后凸成形术允许低压注入骨水泥，并有机会矫正脊柱畸形。需要进一步研究来确定这些技术的确切适应症、时机和相对优点。
