Hai Yong, Chen Xiao-ming, Wu Ji-gong, Liu Yu-zeng, Zhou Li-jin, Zou De-wei
Department of Orthopedic Surgery, 306th Hospital of People's Liberation Army, Beijing 100101, China.
Zhonghua Yi Xue Za Zhi. 2006 Nov 21;86(43):3035-8.
To evaluate the efficacy and safety of kyphoplasty for treatment of non-osteoporotic compressive fractures of thoracolumbar vertebrae.
Seven patients of non-osteoporotic thoracolumbar compressive fractures confirmed by plain X-ray examination and CT scanning, 14 males and 3 females, aged 35.2, all suffering from one level fracture, at T9 in 1 case, T11 in 2 cases, T12 in 7 cases, L1 in 5 cases, L2 in 1 case, and L3 in 1 case were. treated with percutaneous kyphoplasty. Under local anesthesia Kypho-X vertebra expander was inserted into the vertebral body and polymethylmethacrylate (PMMA) bone cement was filled. Then the patients were followed up for 6 months (6-24 months) by using the visual analog scale, Oswestry disability index (ODI), and the vertebra height and kyphosis were analyzed.
All patients underwent the procedure safely. Except for two cases with complication of para-vertebra cement leakage no other complication occurred. The average surgery time was 55 min. All patients became able to get up of bed 2 days and discharged 7 days postoperatively and continued to be protected by hard prosthesis for two weeks more. The average score of VAS was 8.7 before the operation, and then gradually decreased, to 3.2 and 2.7 1 and 4 weeks postoperatively, and became 2.1 at the last follow-up (all P < 0.05). The average ODI score was 72.3 before the operation, and then gradually decreased to 48.6 and 28.9 1 week and 4 weeks postoperatively, and became 22.4 at the last follow-up (all P < 0.05). The average height of the vertebra was 14.3 mm preoperatively, and increased to 24.7 mm 1 week postoperative and 22.4 mm at the last follow up (both P < 0.05). The kyphosis of the fractured vertebra was 31.1 degrees preoperatively and decreased to 9.6 degrees 1 week postoperatively and 10.9 degrees at the last follow up (both P < 0.05). All patients returned to their previous work and life within 2 months postoperatively.
Percutaneous kyphoplasty is effective and safe in the treatment of non-osteoporotic thoracolumbar compressive fractures with the advantages of minimum invasiveness, fast pain relief and recovery, as well as restoration of vertebra height and correction of kyphosis.
评估椎体后凸成形术治疗非骨质疏松性胸腰椎压缩性骨折的疗效和安全性。
经X线平片及CT扫描确诊的7例非骨质疏松性胸腰椎压缩性骨折患者,男14例,女3例,年龄35.2岁,均为单节段骨折,其中T9 1例,T11 2例,T12 7例,L1 5例,L2 1例,L3 1例,采用经皮椎体后凸成形术治疗。在局部麻醉下,将Kypho-X椎体扩张器插入椎体并注入聚甲基丙烯酸甲酯(PMMA)骨水泥。然后采用视觉模拟评分法、Oswestry功能障碍指数(ODI)对患者进行6个月(6 - 24个月)的随访,并分析椎体高度和后凸畸形情况。
所有患者手术均顺利完成。除2例出现椎旁骨水泥渗漏并发症外,未发生其他并发症。平均手术时间为55分钟。所有患者术后2天即可起床,术后7天出院,并继续佩戴硬支具保护2周。术前VAS平均评分为8.7分,术后逐渐下降,术后1周和4周分别降至3.2分和2.7分,末次随访时为2.1分(均P < 0.05)。术前ODI平均评分为72.3分,术后1周和4周分别降至48.6分和28.9分,末次随访时为22.4分(均P < 0.05)。术前椎体平均高度为14.3mm,术后1周增至24.7mm,末次随访时为22.4mm(均P < 0.05)。骨折椎体的后凸畸形术前为31.1°,术后1周降至9.6°,末次随访时为10.9°(均P < 0.05)。所有患者术后2个月内均恢复至术前工作和生活状态。
经皮椎体后凸成形术治疗非骨质疏松性胸腰椎压缩性骨折有效且安全,具有微创、疼痛缓解快、恢复快以及恢复椎体高度和矫正后凸畸形等优点。