Winking M, Stahl J-P, Oertel M, Schnettler R, Böker D-K
Neurochirurgische Klinik, Justus-Liebig Universität Giessen.
Dtsch Med Wochenschr. 2003 Nov 28;128(48):2525-30. doi: 10.1055/s-2003-44950.
Percutaneous polymethylmethacrylate (PMMA) vertebroplasty is increasingly used in the treatment of back pain related to compression of the vertebral bodies. After the procedure immediate mobilization of the patient is possible. The purpose of the study was to examine the change in quality of life of patients with vertebral collapse achieved by vertebroplasty during a six-month period.
28 patients with osteolytic metastases (mean age 59,7 +/- 7,8 years, 2,1:1male/female ratio) and 38 patients with osteoporotic vertebral collapse (mean age 73 +/- 6 years, 1:3,5male/female ratio ) of the thoracal and lumbar spine were treated with PMMA vertebroplasty and analysed prospectively. After admission, before, six weeks and 6 months after discharge from the hospital patients answered the Oswestry Low Back Pain Disability (OLBPD) questionnaire for assessment of treatment-related changes in disability.
Immediately and 6 months after treatment 83 % of tumor patients and 92 % of ostoporotic patients had significant pain reduction. Extravasation of PMMA beyond the vertebral margins were observed in 26 % of the patients. No treatment-related clinical or neurological complications were observed.
PMMA vertebroplasty is an efficacious and safe method of pain relief for patients with osteolytic metastases or osteoporotic compression with good long-term results.
经皮聚甲基丙烯酸甲酯（PMMA）椎体成形术越来越多地用于治疗与椎体压缩相关的背痛。术后患者可立即活动。本研究的目的是考察椎体成形术在六个月期间对椎体塌陷患者生活质量的改善情况。
对28例患有溶骨性转移瘤（平均年龄59.7±7.8岁，男女比例2.1:1）和38例患有骨质疏松性椎体塌陷（平均年龄73±6岁，男女比例1:3.5）的胸腰椎患者进行了PMMA椎体成形术治疗，并进行前瞻性分析。入院后、出院前、出院六周及六个月后，患者回答奥斯威斯利下腰痛残疾（OLBPD）问卷，以评估与治疗相关的残疾变化。
治疗后即刻及6个月时，83%的肿瘤患者和92%的骨质疏松患者疼痛显著减轻。26%的患者出现PMMA超出椎体边缘外渗。未观察到与治疗相关的临床或神经并发症。
PMMA椎体成形术是一种有效且安全的缓解溶骨性转移瘤或骨质疏松性压缩患者疼痛的方法，长期效果良好。
