Department of Orthopaedic Surgery and Traumatology, La Milétrie Teaching Hospital, Poitiers, France.
Orthop Traumatol Surg Res. 2012 Feb;98(1):39-47. doi: 10.1016/j.otsr.2011.08.009. Epub 2011 Dec 30.
We conducted a prospective, single-center, continuous study of patients operated for fractures urelated to osteoporosis at the thoracolumbar junction level using percutaneous techniques. The aim of this study was to investigate the clinical and radiological outcomes of percutaneous techniques for these indications.
This study included patients who underwent standalone balloon kyphoplasty surgery or combined with percutaneous posterior osteosynthesis in cases of associated distraction. The fractures were classified according to the Magerl classification. The patients were evaluated clinically (visual analog scale [VAS], the Oswestry Disability Index, and autonomy) and radiologically (vertebral kyphosis and height variations of the vertebral body) for 12 months.
Sixty-five patients were included. The mean age at the time of the surgery was 45.4 years (range, 19-72 years). The main indications were A.1 fractures of L1. We noted 22% cement leakages, none having a clinical impact. In the overall series, the VAS at the lesional level improved from 5.5 (range, 3-8) preoperatively to 0.6 (range, 1-3) at 12 months. In all, 95% of the workers resumed their occupation. Traumatic kyphosis improved from 13.3° (range, 5-23°) before the surgery to 8.3° (range, 1-20°).
The complication rate was low. The radiological results are comparable to those reported in the literature for other series with percutaneous surgery. Only the loss of the correction observed in the group undergoing standalone kyphoplasty with calcium phosphate cement led us to propose another type of treatment for these indications. This study must be continued over the long term to detect the appearance of discopathy related to cement leakage and to answer questions as to how cement evolves.
III, prospective study with low statistical power.
我们进行了一项前瞻性、单中心、连续研究，纳入了在胸腰椎交界水平使用经皮技术治疗与骨质疏松无关的骨折患者。本研究旨在探讨经皮技术治疗这些适应证的临床和影像学结果。
本研究纳入了单独行球囊扩张椎体后凸成形术或在存在分离的情况下联合经皮后路内固定术的患者。骨折根据 Magerl 分类进行分类。患者在术后 12 个月时进行临床（视觉模拟评分 [VAS]、Oswestry 功能障碍指数和自理能力）和影像学（椎体后凸畸形和椎体高度变化）评估。
共纳入 65 例患者。手术时的平均年龄为 45.4 岁（19-72 岁）。主要适应证为 A.1 型 L1 骨折。我们发现有 22%的骨水泥渗漏，但无临床影响。在整个系列中，病变水平的 VAS 从术前的 5.5（3-8）改善至术后 12 个月时的 0.6（1-3）。所有工人中，95%恢复了工作。创伤性后凸畸形从术前的 13.3°（5-23°）改善至术后 12 个月时的 8.3°（1-20°）。
并发症发生率低。影像学结果与文献中报道的其他经皮手术系列结果相当。仅行单独球囊扩张椎体后凸成形术且使用磷酸钙骨水泥的患者中观察到矫正丢失，这促使我们为这些适应证提出另一种治疗方法。这项研究必须长期进行，以发现与骨水泥渗漏相关的椎间盘病的出现，并解答关于骨水泥如何演变的问题。
III 级，具有低统计学效能的前瞻性研究。
