Nishioka Kazuya, Imae Shinji, Kitayama Mari, Miki Jun-Ichiro, Okawa Toshika, Itakura Toru
Department of Neurological Surgery, Wakayama Medical University, Wakayama.
Neurol Med Chir (Tokyo). 2009 Nov;49(11):501-6. doi: 10.2176/nmc.49.501.
Vertebroplasty with hydroxyapatite blocks through a modified percutaneous approach was used to treat 30 patients with vertebral body fractures in 32 vertebral bodies between February 2003 and March 2007. The mean follow-up period was 16.6 months. The pain associated with this procedure, effects on adjacent vertebral bodies, and other complications were evaluated. The rate of recollapse after vertebroplasty was examined in 26 patients with 26 vertebral bodies treated and followed up for more than 3 months. Mean time of operation was 57 minutes and mean number of blocks used per vertebral body was 104. The mean visual analogue scale score was 7.0 preoperatively and 1.6 postoperatively. The mean decline in postoperative vertebral body height was 13%. New vertebral body fractures occurred postoperatively in 3 vertebral bodies in 2 patients. Leakage of blocks outside the vertebral body occurred in 2 patients during the operation, and after the operation in one patient, and the hydroxyapatite plug broke postoperatively in one patient. Hydroxyapatite blocks yielded good pain relief comparable to bone cement, with no serious complications such as a pulmonary embolism or leakage into the spinal canal, and are effective for percutaneous vertebroplasty.
2003年2月至2007年3月期间，采用改良经皮入路的羟基磷灰石块椎体成形术治疗32个椎体的30例椎体骨折患者。平均随访时间为16.6个月。评估了该手术相关的疼痛、对相邻椎体的影响及其他并发症。对26例接受治疗且随访超过3个月的26个椎体进行了椎体成形术后再塌陷率检查。平均手术时间为57分钟，每个椎体平均使用的骨块数量为104块。术前视觉模拟评分平均为7.0，术后为1.6。术后椎体高度平均下降13%。2例患者的3个椎体术后发生新的椎体骨折。2例患者术中及1例患者术后发生骨块渗漏至椎体外部，1例患者术后羟基磷灰石塞破裂。羟基磷灰石块与骨水泥一样能有效缓解疼痛，无肺栓塞或渗漏至椎管等严重并发症，对经皮椎体成形术有效。
