Kobayashi Kiyokazu, Shimoyama Keiji, Nakamura Keiya, Murata Kiyoshi
Department of Radiology, Kyoto Renaiss Hospital, 1-38 Suehiro-cho, Fukuchiyama, Kyoto, 620-0054, Japan.
Eur Radiol. 2005 Feb;15(2):360-7. doi: 10.1007/s00330-004-2549-0. Epub 2004 Nov 25.
To assess the immediate efficacy of percutaneous vertebroplasty (PVP) in relief of pain and improving mobility of patients with vertebral compression fractures (VCF) secondary to osteoporosis, 205 cases (175 patients) underwent 250 percutaneous injections of polymethylmethacrylate (PMMA; unilateral, 247 levels; bilateral, 3 levels) into vertebrae under CT and fluoroscopic guidance for 34 months. Patients were prospectively asked to quantify their pain on a visual analog scale (VAS) before and a day after PVP. The interval to mobilization was recorded in those who were immobilized because of pain and/or bed-rest therapy (115 cases). PVP was technically successful in all patients, with three cases of minimal complications. The mean VAS score available for 196 cases was improved from 7.22+/-1.89 (range, 3-10) to 2.07+/-1.19 (range, 0-10) by PVP. Ninety-four of 115 immobilized cases (81.7%) were mobile by 24 h after PVP, and the mean value was 1.9+/-2.8 days. The incidence of recurrent and new fractures was 15.6% in 4-25 months (mean, 15.3 months). PVP is a safe and effective treatment for relieving the pain associated with osteoporotic VCF and strengthening the vertebrae, avoiding refractures. This therapy leads to early mobilization and avoidance of the dangers of conservative therapy of bed-rest.
为评估经皮椎体成形术(PVP)对缓解骨质疏松继发椎体压缩骨折(VCF)患者疼痛及改善活动能力的即时疗效,205例(175名患者)在CT和透视引导下接受了250次经皮向椎体内注射聚甲基丙烯酸甲酯(PMMA;单侧,247个椎体节段;双侧,3个椎体节段),随访34个月。前瞻性地要求患者在PVP术前及术后1天用视觉模拟评分法(VAS)对疼痛进行量化。记录因疼痛和/或卧床治疗而制动患者(115例)的活动间隔时间。PVP技术上在所有患者中均获成功,有3例出现轻微并发症。196例患者的平均VAS评分从7.22±1.89(范围3 - 10)经PVP后改善至2.07±1.19(范围0 - 10)。115例制动患者中有94例(81.7%)在PVP术后24小时即可活动,平均时间为1.9±2.8天。4 - 25个月(平均15.3个月)内再发骨折和新发骨折的发生率为15.6%。PVP是一种安全有效的治疗方法,可缓解与骨质疏松性VCF相关的疼痛并强化椎体,避免再骨折。该治疗可促使患者早期活动并避免卧床保守治疗的风险。