Department of Diagnostic and Molecular Imaging, Interventional Radiology, Nuclear Medicine and Radiation Therapy, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
Clin Orthop Relat Res. 2011 Mar;469(3):715-22. doi: 10.1007/s11999-010-1550-y.
Percutaneous vertebroplasty is currently an alternative for treating vertebral fractures of the thoracic and lumbar spine, providing both pain control and vertebral stabilization. In the cervical spine, however, percutaneous vertebroplasty is technically challenging because of the complex anatomy of this region.
QUESTIONS/PURPOSES: We evaluated the technical feasibility, complication rate, and ability of percutaneous vertebroplasty to provide pain relief in patients with painful metastatic cervical fractures.
We retrospectively reviewed 62 patients (24 men) who, between May 2005 and May 2009, underwent vertebroplasty to treat painful metastatic cervical fractures. Each patient was evaluated by a visual analog scale for pain, number of pain analgesics, and CT and MRI before, the day after, and at 3 months after the procedure.
Two of the 62 patients had asymptomatic cement leakage in the soft tissues. We observed no delayed complications. Mean pretreatment and 24-hour posttreatment visual analog scale pain scores were 7.9±1.7 and 1.5±2, respectively. Immediately after surgery, the pain completely disappeared in 25 (40%) patients. Administration of analgesics was suspended in 34 (55%) patients whereas in 27 (39%) patients the median analgesics use decreased from two pills per day (range, 0-3) to 0 (range, 0-3). In two (3%) patients, analgesics administration was continued due to the persistence of pain. At 3 months, the patients reported a mean visual analog scale pain score of 1.7±2.
Our data suggest, in selected patients, percutaneous vertebroplasty may be performed with a high technical success rate combined with a low complication rate, providing immediate pain relief lasting at least 3 months and a reduction in the use of analgesic drugs.
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
经皮椎体成形术目前是治疗胸腰椎椎体骨折的一种替代方法，既能控制疼痛，又能稳定椎体。然而，由于颈椎区域的解剖结构复杂，经皮椎体成形术在颈椎中技术上具有挑战性。
问题/目的：我们评估了经皮椎体成形术治疗疼痛性转移性颈椎骨折患者的技术可行性、并发症发生率以及缓解疼痛的能力。
我们回顾性分析了 2005 年 5 月至 2009 年 5 月期间 62 例（24 例男性）接受椎体成形术治疗疼痛性转移性颈椎骨折的患者。每位患者均通过视觉模拟评分法（VAS）评估疼痛、止痛药的数量以及 CT 和 MRI，分别在术前、术后第 1 天和术后 3 个月进行。
62 例患者中有 2 例出现无症状的软组织水泥渗漏。我们未观察到延迟性并发症。术前和术后 24 小时的平均 VAS 疼痛评分分别为 7.9±1.7 和 1.5±2。术后立即，25 例（40%）患者的疼痛完全消失。34 例（55%）患者停止使用止痛药，而 27 例（39%）患者的止痛药中位数使用量从每天 2 片（范围 0-3）减少至 0（范围 0-3）。在 2 例（3%）患者中，由于疼痛持续存在，继续使用止痛药。在 3 个月时，患者报告平均 VAS 疼痛评分为 1.7±2。
我们的数据表明，在选择的患者中，经皮椎体成形术可以在高技术成功率和低并发症率的情况下进行，可立即缓解疼痛，至少持续 3 个月，并减少镇痛药的使用。
IV 级，治疗研究。欲了解完整的证据水平描述，请参见作者指南。
