Pflugmacher R, Kandziora F, Schroeder R J, Melcher I, Haas N P, Klostermann C K
Centrum für Muskuloskeletale Chirurgie, Abteilung für Radiologie, Universitätsmedizin Berlin, Charité Campus Virchow-Klinikum, Berlin, Germany.
Acta Radiol. 2006 May;47(4):369-76. doi: 10.1080/02841850600570425.
To evaluate the clinical and radiographic outcomes of balloon kyphoplasty in patients with fractures of the thoracic and lumbar spine caused by multiple myeloma.
Vertebral fractures due to multiple myeloma were treated by balloon kyphoplasty (20 patients, 48 vertebral bodies). Symptomatic levels were identified by clinical presentation, magnetic resonance imaging (MRI), radiographs, and computed tomography (CT). During the following year, visual analog scale (VAS) and Oswestry disability score were documented. Radiographs were taken pre- and postoperatively at 3, 6, and 12 months. Vertebral height and kyphotic deformity were measured to assess restoration of the sagittal alignment.
The median pain scores (VAS) decreased significantly from pre- to posttreatment, as did the Oswestry disability score (p < 0.05). Clinically asymptomatic cement leakage occurred at 5 fracture levels (10.4%). During 1-year follow-up, this surgical technique demonstrated restoration and stabilization of the height of the vertebral body.
Balloon kyphoplasty is an effective minimally invasive procedure for stabilizing pathological vertebral fractures caused by multiple myeloma and leading to a statistically significant reduction of pain status. Balloon kyphoplasty stabilizes the vertebral body height, but is only partially able to prevent further kyphotic deformities.
评估球囊椎体后凸成形术治疗多发性骨髓瘤所致胸腰椎骨折患者的临床及影像学结果。
采用球囊椎体后凸成形术治疗20例多发性骨髓瘤所致椎体骨折患者（48个椎体）。通过临床表现、磁共振成像（MRI）、X线片及计算机断层扫描（CT）确定有症状的椎体节段。在接下来的一年中，记录视觉模拟评分（VAS）和Oswestry功能障碍评分。分别在术前及术后3、6和12个月拍摄X线片。测量椎体高度和后凸畸形以评估矢状位对线的恢复情况。
治疗前后，中位疼痛评分（VAS）及Oswestry功能障碍评分均显著降低（p < 0.05）。5个骨折椎体节段（10.4%）出现临床上无症状的骨水泥渗漏。在1年的随访期间，该手术技术显示椎体高度得以恢复并保持稳定。
球囊椎体后凸成形术是一种有效的微创手术，可稳定多发性骨髓瘤所致的病理性椎体骨折，并在统计学上显著减轻疼痛状态。球囊椎体后凸成形术可稳定椎体高度，但仅能部分预防进一步的后凸畸形。
