Ha K-Y, Lee J-S, Kim K-W, Chon J-S
The Catholic University of Korea, and Department of Orthopaedic Surgery, Dongshin General Hospital, Hogeun-dong 430, Seodaemoon-gu, Seoul 120-848, Korea.
J Bone Joint Surg Br. 2006 May;88(5):629-33. doi: 10.1302/0301-620X.88B5.17345.
We present the clinical and radiological results of percutaneous vertebroplasty in the treatment of 58 vertebral compression fractures in 51 patients at a minimum follow-up of two years. Group 1 consisted of 39 patients, in whom there was no associated intravertebral cleft, whilst group 2 comprised 12 patients with an intravertebral cleft. The Oswestry disability index (ODI) and visual analogue scale (VAS) scores were recorded prospectively. The radiological evidence of kyphotic deformity, vertebral height, leakage of cement and bone resorption around the cement were studied retrospectively, both before and after operation and at the final follow-up. The ODI and VAS scores in both groups decreased after treatment, but the mean score in group 2 was higher than that in group 1 (p = 0.02 (ODI), p = 0.02 (VAS)). There was a greater initial correction of the kyphosis in group 2 than in group 1, although the difference was not statistically significant. However, loss of correction was greater in group 2. Leakage of cement was seen in 24 (41.4%) of 58 vertebrae (group 1, 32.6% (15 of 46); group 2, 75% (9 of 12)), mainly of type B through the basal vertebral vein in group 1 and of type C through the cortical defect in group 2. Resorption of bone around the cement was seen in three vertebrae in group 2 and in one in group 1. There were seven adjacent vertebral fractures in group 1 and one in group 2. Percutaneous vertebroplasty is an effective treatment for osteoporotic compression fractures with or without an intravertebral cleft. Nonetheless, higher rates of complications related to the cement must be recognised in patients in the presence of an intravertebral cleft.
我们报告了经皮椎体成形术治疗51例患者58处椎体压缩骨折的临床和放射学结果，随访时间至少为两年。第1组由39例患者组成，这些患者不存在相关的椎体内裂隙，而第2组由12例有椎体内裂隙的患者组成。前瞻性记录奥斯威斯功能障碍指数（ODI）和视觉模拟评分（VAS）。回顾性研究术前、术后及最终随访时后凸畸形、椎体高度、骨水泥渗漏及骨水泥周围骨吸收的放射学证据。两组治疗后ODI和VAS评分均降低，但第2组的平均评分高于第1组（P=0.02（ODI），P=0.02（VAS））。第2组后凸畸形的初始矫正程度大于第1组，尽管差异无统计学意义。然而，第2组的矫正丢失更大。58个椎体中有24个（41.4%）出现骨水泥渗漏（第1组，46个中有15个，占32.6%；第2组，12个中有9个，占75%），第1组主要为B型通过椎体基底静脉渗漏，第2组为C型通过皮质缺损渗漏。第2组有3个椎体出现骨水泥周围骨吸收，第1组有1个椎体出现骨水泥周围骨吸收。第1组有7例相邻椎体骨折，第2组有1例相邻椎体骨折。经皮椎体成形术是治疗有或无椎体内裂隙的骨质疏松性压缩骨折的有效方法。尽管如此，存在椎体内裂隙的患者必须认识到与骨水泥相关的并发症发生率更高。
