Nieuwenhuijse Marc J, Dijkstra P D Sander
Leids Universitair Medisch Centrum, Leiden, Afd. Orthopedie, the Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A2199.
Percutaneous vertebral augmentation, with percutaneous vertebroplasty (PVP) as its most widely used variant, is currently the only intervention for painful osteoporotic compression fractures. This procedure offers immediate and substantial pain relief in over 80% of treated patients with a low reported complication rate (< 1.6%). A large number of studies have shown promising results and the superiority of this treatment over conservative treatment has been established. Results of the first two, long-awaited, placebo-controlled trials were unexpected: improvement after PVP was similar to improvement after placebo treatment. Limitations in the design of both trials prevented widespread implementation of the results. We believe that PVP cannot be regarded as an obsolete treatment as long as patients are carefully selected. Patients with persistent (over 2 months) and painful osteoporotic vertebral fractures have been shown to benefit from vertebroplasty and are therefore suitable candidates for this procedure, which, in these cases, can prevent complications due to long-term disabling pain.
经皮椎体强化术，其中经皮椎体成形术（PVP）是其应用最广泛的变体，目前是治疗骨质疏松性疼痛性压缩骨折的唯一干预措施。该手术能为超过80%的接受治疗的患者带来即时且显著的疼痛缓解，报告的并发症发生率较低（<1.6%）。大量研究已显示出有前景的结果，且已证实该治疗优于保守治疗。前两项期待已久的安慰剂对照试验结果出人意料：PVP术后的改善与安慰剂治疗后的改善相似。两项试验设计上的局限性阻碍了结果的广泛应用。我们认为，只要仔细挑选患者，PVP就不能被视为过时的治疗方法。已证明持续性（超过2个月）疼痛性骨质疏松性椎体骨折患者可从椎体成形术中获益，因此是该手术的合适候选者，在这些情况下，该手术可预防因长期致残性疼痛导致的并发症。
