Kim Hyeun Sung, Kim Seok Won, Ju Chang Il
Department of Neurosurgery , Mokpo Hankook Hospital, Mokpo, Korea.
J Korean Neurosurg Soc. 2007 Nov;42(5):363-6. doi: 10.3340/jkns.2007.42.5.363. Epub 2007 Nov 20.
Kyphoplasty performed in the middle thoracic spine presents technical challenges that differ from those in the lower thoracic or lumbar region due to small pedicle size and angular severity for thoracic kyphosis. The purpose of this study was to evaluate the efficacy of balloon kyphoplasty through extrapedicular approach for the treatment of intractable osteoporotic compression fractures in the middle thoracic spine.
The patients who were performed with one level balloon kyphoplasty through extrapedicular approach due to painful osteoporotic compression fractures at T5-T8 from June 2003 to July 2005 were retrospectively analyzed. Imaging and clinical features were analyzed including involved vertebrae level, vertebral height, injected cement volume, clinical outcome and complications.
Eighteen female patients (age ranged from 60 to 77 years old) were included in this study. The average amount of the implanted cement was 4.2+/-1.5 cc. The mean cobb angle and compression rate were improved from 12.1+/-6.5 degrees to 8.5+/-7.2 degrees and from 30% to 15%, respectively. The mean pain score (visual analogue scale) prior to kyphoplasty was 7.9 and it decreased to 3.0 after the procedure. Cement leakage to the adjacent disc (2 cases) and paravertebral soft tissues (1 case) were seen but there were no major complications such as pneumothorax, segmental artery injury, pulmonary embolism, or epidural leakage.
Balloon kyphoplasty through extrapedicular approach is considered as a safe and effective in treating the middle thoracic regions with low complication rate.
由于胸椎椎弓根尺寸较小以及胸椎后凸角度较大，胸椎中段进行椎体后凸成形术存在与胸腰段或腰段不同的技术挑战。本研究的目的是评估经椎弓根外入路球囊椎体后凸成形术治疗胸椎中段顽固性骨质疏松性压缩骨折的疗效。
回顾性分析2003年6月至2005年7月因T5 - T8节段疼痛性骨质疏松性压缩骨折行经椎弓根外入路单节段球囊椎体后凸成形术的患者。分析影像学和临床特征，包括受累椎体节段、椎体高度、注入骨水泥量、临床结果及并发症。
本研究纳入18例女性患者（年龄60至77岁）。骨水泥平均植入量为4.2±1.5立方厘米。平均Cobb角和压缩率分别从12.1±6.5度改善至8.5±7.2度，从30%改善至15%。椎体后凸成形术前平均疼痛评分（视觉模拟评分）为7.9分，术后降至3.0分。观察到2例骨水泥渗漏至相邻椎间盘，1例渗漏至椎旁软组织，但未出现气胸、节段动脉损伤、肺栓塞或硬膜外渗漏等严重并发症。
经椎弓根外入路球囊椎体后凸成形术治疗胸椎中段被认为是安全有效的，并发症发生率低。
