Masala Salvatore, Mastrangeli Roberta, Petrella Maria Chiara, Massari Francesco, Ursone Antonio, Simonetti Giovanni
Department of Diagnostic and Molecular Imaging, Interventional Radiology and Radiotherapy, Università di Roma Tor Vergata, Rome, Italy.
Eur Radiol. 2009 Jan;19(1):165-71. doi: 10.1007/s00330-008-1133-4. Epub 2008 Aug 15.
Several authors claim that vertebroplasty (PVT) is a successful technique, but long-term effectiveness is still debated. Our goal was to evaluate the effectiveness of PVT in patients with symptomatic vertebral fractures that had not responded to conservative treatment. In our centre, 624 patients with 1,253 compression fractures were treated by PVT. Imaging studies, clinical visits and short- and long-term follow-up were assessed by visual analogue scale (VAS) testing of pain. Statistical analysis was performed to evaluate pain response after PVT (paired two-tailed t-test) and to assess any differences in pain due to different lesions (ANOVA test). We found a statistically significant improvement in the patients' quality of life, particularly in pain (P < 0.001). The average VAS value pre-PVT was 8.0 +/- 2.5, which significantly dropped to 1.5 +/- 0.4 by 12 months. There were no significant differences in pain response between the groups of patients with different underlying disease. There was a low complication rate in our study. PVT should be considered the treatment of choice in vertebral fractures with refractory pain. With strict evaluation of the clinical indications and sub-specialised operators, long-term effectiveness is probable.
几位作者声称椎体成形术（PVT）是一种成功的技术，但长期有效性仍存在争议。我们的目标是评估PVT对保守治疗无效的有症状椎体骨折患者的有效性。在我们中心，624例患者的1253处压缩性骨折接受了PVT治疗。通过疼痛视觉模拟量表（VAS）测试对影像学研究、临床检查以及短期和长期随访进行评估。进行统计分析以评估PVT后的疼痛反应（配对双尾t检验），并评估不同病变导致的疼痛差异（方差分析）。我们发现患者的生活质量有统计学意义的改善，尤其是疼痛方面（P < 0.001）。PVT前平均VAS值为8.0±2.5，到12个月时显著降至1.5±0.4。不同基础疾病的患者组之间疼痛反应无显著差异。我们的研究并发症发生率较低。对于难治性疼痛的椎体骨折，PVT应被视为首选治疗方法。通过严格评估临床适应症和专业操作人员，长期有效性是有可能的。
