Phillips Frank M, Ho Erling, Campbell-Hupp Marion, McNally Thomas, Todd Wetzel F, Gupta Pernendu
The University of Chicago Spine Center, Chicago, Illinois, USA.
Spine (Phila Pa 1976). 2003 Oct 1;28(19):2260-5; discussion 2265-7. doi: 10.1097/01.BRS.0000085092.84097.7B.
A prospective consecutive cohort study of clinical and radiographic outcomes after kyphoplasty for treatment of osteoporotic vertebral compression fractures.
To measure changes in spinal deformity, activity level, and pain after kyphoplasty treatment.
Pain and kyphosis caused by osteoporotic vertebral compression fractures adversely affect quality of life and survival. Kyphoplasty involves the inflation of a balloon bone tamp, percutaneously placed in a fractured vertebral body, followed by deposition of bone cement into the resulting cavity. Previous reports indicate that kyphoplasty improves patient function and restores height of collapsed vertebral bodies, but limited data about the effects of kyphoplasty on spinal sagittal alignment are available.
Twenty-nine patients with osteoporotic vertebral compression fractures who did not respond to medical therapy were treated by kyphoplasty. These patients underwent 37 operations to treat 61 vertebral compression fractures between T6 and L5. Sagittal alignment was analyzed from standing radiographs (pre- and postkyphoplasty). Patient surveys were used to assess pain relief, improvement in activity, and satisfaction with the surgical procedure.
In this cohort, a mean of 8.8 degrees (range 0-29 degrees ) of correction of local spinal kyphosis was achieved with kyphoplasty. Thirty of 52 fractures (17 patients) were considered reducible and had >5 degrees of correction, with a mean improvement in sagittal alignment of this population of 14.2 degrees. Patient surveys revealed significant pain reduction within the first week after surgery and improved activity levels for a majority of patients.
Kyphoplasty improves physical function, reduces pain, and may correct kyphotic deformity associated with vertebral compression fractures.
一项关于经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折后临床及影像学结果的前瞻性连续队列研究。
测量椎体后凸成形术治疗后脊柱畸形、活动水平及疼痛的变化。
骨质疏松性椎体压缩骨折所致疼痛和后凸畸形对生活质量及生存率产生不利影响。椎体后凸成形术包括经皮在骨折椎体中置入球囊骨扩张器并充气，随后向形成的腔隙内注入骨水泥。既往报告表明，椎体后凸成形术可改善患者功能并恢复塌陷椎体的高度，但关于椎体后凸成形术对脊柱矢状面排列影响的数据有限。
29例对保守治疗无反应的骨质疏松性椎体压缩骨折患者接受了椎体后凸成形术治疗。这些患者共接受了37次手术，治疗T6至L5节段的61处椎体压缩骨折。通过站立位X线片（椎体后凸成形术前、后）分析矢状面排列情况。采用患者调查问卷评估疼痛缓解情况、活动改善情况及对手术的满意度。
在该队列中，椎体后凸成形术平均矫正局部脊柱后凸8.8度（范围0 - 29度）。52处骨折中的30处（17例患者）被认为可复位，矫正度数>5度，该组患者矢状面排列平均改善14.2度。患者调查问卷显示，术后第一周内疼痛显著减轻，大多数患者的活动水平有所改善。
椎体后凸成形术可改善身体功能、减轻疼痛，并可能矫正与椎体压缩骨折相关的后凸畸形。
