Gan Minfeng, Yang Huilin, Zhou Feng, Zou Jun, Wang Genlin, Mei Xin, Qian Zhonglai, Chen Liang
Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, China.
Orthopedics. 2010 Feb;33(2):88-92. doi: 10.3928/01477447-20100104-17.
This study explored the feasibility and clinical outcome of kyphoplasty for the treatment of painful osteoporotic thoracolumbar burst fractures without neurological deficit. A total of 25 consecutive patients with painful type-A3 amyelic thoracolumbar fractures without neurological deficit were treated by kyphoplasty. Pain was measured using the self-reporting visual analog pain scale (VAS) preoperatively, postoperatively, and at 6-month follow-up. Disability was measured using the Oswestry Disability Index (ODI) preoperatively, postoperatively, and at 6-month follow-up. The height of the fractured vertebral body, kyphotic angle, and spinal canal compromise were measured preoperatively, postoperatively, and at 6-month follow-up. Relief of pain was achieved 24 hours postoperatively. Mean VAS score decreased from 8.2+/-1.3 preoperatively to 2.8+/-0.8 postoperatively (P<.05), and was maintained at 2.9+/-1.1 at 6-month follow-up. The ODI score varied from 68.2%+/-6.6% preoperatively to 35.3%+/-2.8% postoperatively (P<.05). Improvement was maintained at 6-month follow-up. Postoperatively, the height of anterior vertebrae (Ha) was restored from 61.5%+/-13.9% to 85.3%+/-10.6%, the height of midline vertebrae (Hm) restored from 73.0%+/-19.3% to 83.3%+/-7.4%, the kyphotic angle from 21.7 degrees +/-7.8 degrees to 8.6 degrees +/-6.6 degrees, and the spinal canal compromise from 20.1%+/-4.1% to 17.8%+/-1.3%. At 6-month follow-up, maintenance of the height restoration and kyphotic deformity correction was found. No significant difference was noted in pre- and postoperative spinal canal compromise. Kyphoplasty is a relatively safe and effective method for the treatment of painful osteoporotic thoracolumbar burst fractures.
本研究探讨了椎体后凸成形术治疗无神经功能缺损的疼痛性骨质疏松性胸腰椎爆裂骨折的可行性及临床疗效。共有25例连续性无神经功能缺损的疼痛性A型3无脊髓损伤的胸腰椎骨折患者接受了椎体后凸成形术治疗。分别在术前、术后及6个月随访时，使用自报告视觉模拟疼痛量表（VAS）测量疼痛程度。分别在术前、术后及6个月随访时，使用Oswestry功能障碍指数（ODI）测量功能障碍程度。分别在术前、术后及6个月随访时，测量骨折椎体的高度、后凸角及椎管狭窄情况。术后24小时疼痛即得到缓解。平均VAS评分从术前的8.2±1.3降至术后的2.8±0.8（P<0.05），在6个月随访时维持在2.9±1.1。ODI评分从术前的68.2%±6.6%降至术后的35.3%±2.8%（P<0.05）。在6个月随访时仍保持改善。术后，椎体前缘高度（Ha）从61.5%±13.9%恢复至85.3%±10.6%，椎体中线高度（Hm）从73.0%±19.3%恢复至83.3%±7.4%，后凸角从21.7°±7.8°降至8.6°±6.6°，椎管狭窄从20.1%±4.1%降至17.8%±1.3%。在6个月随访时，发现椎体高度恢复及后凸畸形矫正得以维持。术前和术后椎管狭窄情况无显著差异。椎体后凸成形术是治疗疼痛性骨质疏松性胸腰椎爆裂骨折的一种相对安全有效的方法。
