Phillips Frank M
University of Chicago Spine Center, Chicago, Illinois 60640, USA.
Spine (Phila Pa 1976). 2003 Aug 1;28(15 Suppl):S45-53. doi: 10.1097/01.BRS.0000076898.37566.32.
A literature review of experiences with vertebroplasty and kyphoplasty for treating symptomatic, osteoporotic vertebral compression fractures (VCFs).
To summarize the advantages and disadvantages of kyphoplasty and vertebroplasty.
Osteoporotic VCFs are a leading cause of disability and morbidity in the elderly. The consequences of osteoporotic VCFs (pain and often progressive vertebral collapse with resultant spinal kyphosis) adversely affect quality of life, physical function, mental health, and survival. Vertebroplasty and kyphoplasty are minimally invasive procedures for treating painful fractures. Vertebroplasty entails the percutaneous injection of bone cement into the fractured vertebra in attempts to stabilize the fracture and reduce pain. Kyphoplasty addresses pain and kyphotic deformity by the percutaneous expansion of an inflatable bone tamp to effect fracture reduction before cement deposition in a fractured vertebra.
A literature review of surgical techniques, indications, clinical results, and complications for vertebroplasty and kyphoplasty.
Studies of vertebroplasty and kyphoplasty have reported excellent pain relief and improved function in most patients with osteoporotic VCFs. Vertebroplasty has the advantage of being relatively quick and inexpensive. Kyphoplasty, while associated with increased cost and surgical time, offers the potential to improve spinal alignment. In addition, by creating an intravertebral cavity, kyphoplasty reduces the risk of extravertebral bone filler extravasation.
Vertebroplasty and kyphoplasty are currently used to treat osteoporotic VCFs with successful short-term results. Prospective, randomized studies comparing these procedures to one another and comparing their long-term outcomes to conventional medical management are required to define precise roles of these exciting treatments in the spine physician's armamentarium.
对椎体成形术和后凸成形术治疗有症状的骨质疏松性椎体压缩骨折（VCF）的经验进行文献综述。
总结后凸成形术和椎体成形术的优缺点。
骨质疏松性VCF是老年人致残和发病的主要原因。骨质疏松性VCF的后果（疼痛以及常伴有椎体逐渐塌陷并导致脊柱后凸）对生活质量、身体功能、心理健康和生存产生不利影响。椎体成形术和后凸成形术是治疗疼痛性骨折的微创手术。椎体成形术需要经皮将骨水泥注入骨折椎体，试图稳定骨折并减轻疼痛。后凸成形术通过经皮扩张可膨胀骨填充器来解决疼痛和后凸畸形，以便在向骨折椎体注入骨水泥之前实现骨折复位。
对椎体成形术和后凸成形术的手术技术、适应证、临床结果及并发症进行文献综述。
对椎体成形术和后凸成形术的研究报告称，大多数骨质疏松性VCF患者的疼痛得到了显著缓解，功能也有所改善。椎体成形术的优点是相对快速且成本较低。后凸成形术虽然成本和手术时间增加，但有可能改善脊柱排列。此外，通过形成椎体内腔，后凸成形术降低了椎体外骨填充剂渗漏的风险。
椎体成形术和后凸成形术目前用于治疗骨质疏松性VCF，短期效果良好。需要进行前瞻性、随机研究，将这些手术相互比较，并将其长期结果与传统药物治疗进行比较，以明确这些令人振奋的治疗方法在脊柱医生的治疗手段中的精确作用。
