Berlemann Ulrich, Franz Torsten, Orler Rene, Heini Paul F
Department of Trauma Surgery, Medical School Hannover, Germany.
Eur Spine J. 2004 Oct;13(6):496-501. doi: 10.1007/s00586-004-0691-7. Epub 2004 Apr 9.
Minimally invasive augmentation techniques of vertebral bodies have been advocated to treat osteoporotic vertebral body compression fractures (VBCFs). Kyphoplasty is designed to address both fracture-related pain as well as kyphotic deformity usually associated with fracture. Previous studies have indicated the potential of this technique for reduction of vertebral body height, but there has been little investigation into whether this has a lasting effect. The current study reports on our experience and the one-year results in 27 kyphoplasty procedures (24 patients) for osteoporotic VBCFs.
All but one patient experienced pain relief following the procedure (on VAS 1-10)--with a lasting effect over the follow-up period in 25 cases. An average vertebral kyphosis reduction of 47.7% was achieved with no loss of reduction after one year. The potential for reduction was statistically related to the pre-operative amount of kyphosis, the level treated, and the age of the fracture, but not to the age of the patient. During follow-up, one fracture adjacent to a treated level was observed. Pain relief was not related to the amount of reduction.
Kyphoplasty is an effective treatment of VBCFs in terms of pain relief and durable reduction of deformity. Whether spinal realignment results in an improved long-term clinical outcome remains to be investigated.
椎体微创强化技术已被提倡用于治疗骨质疏松性椎体压缩骨折（VBCF）。椎体后凸成形术旨在解决与骨折相关的疼痛以及通常与骨折相关的后凸畸形。先前的研究表明该技术有恢复椎体高度的潜力，但对于这种效果是否持久却鲜有研究。本研究报告了我们对27例（24名患者）骨质疏松性VBCF行椎体后凸成形术的经验及一年随访结果。
除1例患者外，所有患者术后疼痛均缓解（视觉模拟评分1 - 10分）——25例在随访期内疼痛持续缓解。平均椎体后凸矫正47.7%，一年后矫正度无丢失。矫正潜力在统计学上与术前驼背程度、治疗节段以及骨折年龄相关，但与患者年龄无关。随访期间，观察到1例临近治疗节段发生骨折。疼痛缓解与矫正程度无关。
椎体后凸成形术在缓解疼痛和持久矫正畸形方面是治疗VBCF的有效方法。脊柱矫正是否能改善长期临床疗效仍有待研究。
