Lee Shih-Tseng, Chen Jyi-Feng
Department of Neurosurgery, Chang Gung University & Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.
J Neurosurg. 2004 Apr;100(4 Suppl Spine):392-6. doi: 10.3171/spi.2004.100.4.0392.
The purpose of this study was to determine the efficacy and feasibility of closed reduction vertebroplasty for the treatment of osteoporotic vertebral compression fractures. Two hundred consecutive patients (183 women and 17 men) with single-level osteoporotic vertebral compression fracture were included in this study. After induction of general anesthesia, the patient was placed prone on an operating table. Closed reduction of the fractured and kyphotic spine was achieved by extending the table to restore the kyphotic angle and vertebral body (VB) height. Percutaneous vertebroplasty was then performed to treat the fractured vertebra. The results were quantitatively evaluated, according to the concept of estimated VB height. The anterior, middle, and posterior VB heights of the fractured vertebra were measured preoperatively and immediately after surgery by studying plain standing lateral radiographs. In 162 (81%) of the compression fractures the anterior VB height was restored (57.1 +/- 24.8% of lost anterior VB height); in 152 (76%) of the compression fractures the middle VB height was restored (61.4 +/- 20.6% of lost middle VB height); and in 52 (26%) of the compression fractures the posterior VB height was restored (51.3 +/- 23.1% of lost posterior VB height). In 141 (71.5%) of the compression fractures kyphosis was corrected by 12.5 +/- 3.8 degrees [mean 61.6 +/- 23.7%]). Closed reduction vertebroplasty is an efficacious and simple method in the treatment of osteoporotic vertebral compression fracture and was able to restore the VB height and kyphotic angle in postions of fractured vertebrae. Its associated, long-term effects on treated vertebrae, however, need further evaluation.
本研究的目的是确定闭合复位椎体成形术治疗骨质疏松性椎体压缩骨折的疗效和可行性。本研究纳入了200例连续的单节段骨质疏松性椎体压缩骨折患者（183例女性和17例男性）。全身麻醉诱导后，患者俯卧于手术台上。通过伸展手术台以恢复后凸角和椎体高度，实现骨折和后凸脊柱的闭合复位。然后进行经皮椎体成形术治疗骨折椎体。根据估计的椎体高度概念对结果进行定量评估。通过研究站立位平片侧位片，在术前和术后立即测量骨折椎体的椎体前、中、后高度。在162例（81%）压缩骨折中，椎体前高度得以恢复（恢复了丢失的椎体前高度的57.1±24.8%）；在152例（76%）压缩骨折中，椎体中高度得以恢复（恢复了丢失的椎体中高度的61.4±20.6%）；在52例（26%）压缩骨折中，椎体后高度得以恢复（恢复了丢失的椎体后高度的51.3±23.1%）。在141例（71.5%）压缩骨折中，后凸畸形矫正了12.5±3.8度[平均61.6±23.7%]）。闭合复位椎体成形术是治疗骨质疏松性椎体压缩骨折的一种有效且简单的方法，能够恢复骨折椎体的椎体高度和后凸角。然而，其对治疗椎体的长期相关影响需要进一步评估。
