一期单球囊多次扩张经皮椎体后凸成形术：18例报告

[One-stage single balloon multiple expansions percutaneous kyphoplasty: report of 18 cases].

作者信息

Zheng Zhao-Min, Kuang Guan-Ming, Dong Zhi-Yong, Li Fo-Bao, Lü You, Chen Hui, Liu Hui, Zhang Kui-Bo

机构信息

Department of Spine Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2007 Mar 6;87(9):580-4.

PMID:17550722

Abstract

OBJECTIVE

To observe the effect and safety of one-stage single balloon multiple expansions percutaneous kyphoplasty (PKP) in treatment of osteoporotic vertebral compressive fracture (OVCF) and spinal tumor.

METHODS

One-stage single balloon multiple expansions PKP was performed on 18 patients, 5 males and 13 females, aged 68.77 (44 - 80), with 45 vertebrae, including 11 case of OVCF (with 29 diseased vertebrae), 11 cases of multiple vertebral fracture (with 19 diseased vertebrae), 5 cases of multiple myeloma (with 12 diseased vertebrae), and 2 case of spinal metastatic tumor (with 4 diseased vertebrae), the vital signs were record during operation. Pain relief and functional recovery were evaluated with visual analogue pain scale (VAS) and Oswestry disability index (ODI) scaling, and restoration of vertebral height and Cobb angle were evaluated by X-ray examination. Follow-up was conducted by telephone survey or clinic consults for 12.3 months (6 - 18 months).

RESULTS

Operation was successfully performed on all patients with an operative time of 29.3 min (55 - 127 min) per vertebra. The average pressure of the balloon expansion was 165 Psi (87 - 210 Psi), and the average balloon expanded volume was 3.25 ml (1.5 - 4 ml). A balloon was expanded 2 approximately 5 times in one operation with the average of 2.94 expanded times. The bone cement volume injected was 3.95 ml (2 - 8.5 ml) per vertebra. Epidural cement leakage was seen in 1 vertebra in 1 case and paraspinal leakage was seen in two vertebrae in 1 case. The VAS and ODI scoring of these patients were both decreased significantly after operation. Both the anterior height and midline height of vertebrae were significantly improved. The pain relief and functional recovery were substantial and maintained to the last follow-up without any re-collapse or adjacent level fracture.

CONCLUSION

one-stage single balloon multiple expansions PKP is effective, economic and safe in treatment of multi-level OVCF and spinal tumor.

摘要

目的

观察一期单球囊多次扩张经皮椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩骨折（OVCF）及脊柱肿瘤的疗效及安全性。

方法

对18例患者实施一期单球囊多次扩张PKP，其中男性5例，女性13例，年龄68.77岁（44 - 80岁），共45个椎体，包括11例OVCF（29个病椎）、11例多发性椎体骨折（19个病椎）、5例多发性骨髓瘤（12个病椎）及2例脊柱转移瘤（4个病椎），术中记录生命体征。采用视觉模拟疼痛评分（VAS）和Oswestry功能障碍指数（ODI）评估疼痛缓解及功能恢复情况，通过X线检查评估椎体高度及Cobb角恢复情况。通过电话随访或门诊复诊进行随访，随访时间为12.3个月（6 - 18个月）。

结果

所有患者手术均成功，每个椎体手术时间为29.3分钟（55 - 127分钟）。球囊扩张平均压力为165磅力/平方英寸（87 - 210磅力/平方英寸），球囊平均扩张容积为3.25毫升（1.5 - 4毫升）。一次手术中一个球囊约扩张2至5次，平均扩张次数为2.94次。每个椎体注入骨水泥量为3.95毫升（2 - 8.5毫升）。1例患者1个椎体出现硬膜外骨水泥渗漏，1例患者2个椎体出现椎旁渗漏。术后这些患者的VAS和ODI评分均显著降低。椎体前缘高度和中线高度均显著改善。疼痛缓解及功能恢复明显，至末次随访时无再次塌陷或邻近节段骨折。