Pflugmacher R, Beth P, Schroeder R-J, Schaser K-D, Melcher I
Centrum für Muskuloskeletale Chirurgie and Abteilung für Strahlenheilkunde, Universitätsmedizin Berlin, Charité, Campus Virchow-Klinikum, Augustenburgerplatz 1, 13353 Berlin, Germany.
Acta Radiol. 2007 Feb;48(1):89-95. doi: 10.1080/02841850601026427.
To evaluate the clinical and radiographic outcomes of balloon kyphoplasty in patients with fractures of the thoracic and lumbar spine caused by metastatic disease.
64 balloon kyphoplasty procedures were performed in 31 patients (18 females and 13 males with bone metastasis), 28 of whom were followed up over a period of 1 year. Symptomatic levels were identified by clinical presentation, magnetic resonance imaging (MRI), radiographs, and computed tomography (CT). In the prospective 1-year follow-up, visual analog scale (VAS) and Oswestry Disability Score were documented. Radiographs were performed pre- and postoperatively, and 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 (P<0.05) from pre- to post-treatment, as did the Oswestry Disability Score (P<0.05). Polymethyl methacrylate (PMMA) cement leakage was detected in eight of 64 vertebral bodies (12.5%), but did not have any clinical relevance. During 1-year follow-up, balloon kyphoplasty stabilized vertebral height and prevented further kyphotic deformity.
Balloon kyphoplasty is an effective, minimally invasive procedure for the stabilization of pathological vertebral fractures caused by osteolytic lesions of vertebral bodies due to metastatic disease. It gives a statistically significant reduction of pain and prevents further kyphotic deformity of the spine.
评估球囊椎体后凸成形术治疗转移性疾病所致胸腰椎骨折患者的临床及影像学结果。
对31例骨转移患者（18例女性，13例男性）实施了64例球囊椎体后凸成形术，其中28例进行了为期1年的随访。通过临床表现、磁共振成像（MRI）、X线片和计算机断层扫描（CT）确定有症状的椎体节段。在为期1年的前瞻性随访中，记录视觉模拟评分（VAS）和Oswestry功能障碍评分。在术前、术后以及术后3、6和12个月进行X线片检查。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）显著降低（P<0.05），Oswestry功能障碍评分也显著降低（P<0.05）。在64个椎体中的8个（12.5%）检测到聚甲基丙烯酸甲酯（PMMA）骨水泥渗漏，但无任何临床意义。在1年的随访期间，球囊椎体后凸成形术稳定了椎体高度并防止了进一步的后凸畸形。
球囊椎体后凸成形术是一种有效、微创的手术，可稳定转移性疾病所致椎体溶骨性病变引起的病理性椎体骨折。它在统计学上能显著减轻疼痛并防止脊柱进一步后凸畸形。
