Masala Salvatore, Fiori Roberto, Massari Francesco, Simonetti Giovanni
Dipartimento di Diagnostica per Immagini e Radiologia Interventistica, Università degli Studi di Roma Tor Vergata, Rome.
Radiol Med. 2005 Jul-Aug;110(1-2):97-105.
Percutaneous Kyphoplasty is an emerging Interventional Radiology technique consisting in injecting polymethylmethacrylate (PMMA) into collapsed vertebral bodies under fluoroscopic guidance, after compaction of the cancellous bone with two dedicated balloon catheters. The purpose of our study was to assess the indications, contraindications, technique and results of our initial study.
Between January and May 2003 we treated 11 patients (5 men, 6 women) with vertebral collapse occurred up to three months earlier and due to osteoporosis or myeloma (mean age: 68.9), with pain refractory to medical therapy. All patients underwent treatment on a single vertebra (1 D7; 1 D8; 2 D12; 3 L1; 3 L2; 1 L4). Patient selection was based on clinical and instrumental criteria: conventional radiography, CT and MR were performed on all patients before the procedure. The Visual Analogue Scale (VAS) for pain assessment was used to evaluate the post-procedure results.
All patients showed an increase in the height of the collapsed vertebral body, associated with partial or complete pain relief (VAS score decreasing from a pre-treatment score of 8 to a score of 2 after treatment). No complications related to the procedure were recorded.
The indications for kyphoplasty include recent vertebral compression fractures due to osteoporosis, myeloma, metastasis and vertebral angioma with intractable pain and with no neurological symptoms. The main contraindications are coagulation disorders, unstable fractures or complete vertebral collapse (vertebra plana). Kyphoplasty proved to be a safe and effective method for the treatment of intractable pain due to vertebral collapse that allows for shorter hospital stays and an immediate improvement in the patient's quality of life.
经皮椎体后凸成形术是一种新兴的介入放射学技术，该技术是在使用两根专用球囊导管压实松质骨后，于透视引导下将聚甲基丙烯酸甲酯（PMMA）注入塌陷的椎体。我们这项研究的目的是评估我们初步研究的适应症、禁忌症、技术及结果。
在2003年1月至5月期间，我们治疗了11例患者（5例男性，6例女性），他们的椎体塌陷发生在三个月内，病因是骨质疏松或骨髓瘤（平均年龄：68.9岁），且药物治疗无法缓解疼痛。所有患者均针对单个椎体进行治疗（1例D7；1例D8；2例D12；3例L1；3例L2；1例L4）。患者选择基于临床和影像学标准：术前对所有患者均进行了传统X线摄影、CT及磁共振成像检查。采用视觉模拟评分法（VAS）评估疼痛以评价术后结果。
所有患者塌陷椎体的高度均增加，同时伴有部分或完全的疼痛缓解（VAS评分从治疗前的8分降至治疗后的2分）。未记录到与手术相关的并发症。
椎体后凸成形术的适应症包括因骨质疏松、骨髓瘤、转移瘤及椎体血管瘤导致的近期椎体压缩性骨折，伴有顽固性疼痛且无神经症状。主要禁忌症为凝血功能障碍、不稳定骨折或椎体完全塌陷（椎体扁平）。椎体后凸成形术被证明是一种治疗椎体塌陷所致顽固性疼痛的安全有效方法，可缩短住院时间并能立即改善患者生活质量。
