Department of Orthopaedics and Traumatology, San Raffaele Hospital, Via Olgettina 60, 20123 Milan, Italy.
Eur Spine J. 2012 May;21 Suppl 1(Suppl 1):S108-11. doi: 10.1007/s00586-012-2225-z. Epub 2012 Mar 10.
Vertebroplasty and more recently kyphoplasty are recognized as techniques in the treatment of osteoporotic vertebral fractures and in case of pathological fracture like in secondary tumors. The recent introduction of calcium phosphate cement (CPC) that offers, at least theoretically, an osteointegrative capacity, absent in polymethyl methacrylate (PMMA), has generated interest for its use in the treatment of traumatic fractures (type A) even in young patients.
In this study, type A fractures without neurological signs were treated. A total of six male patients, of age between 21 and 55 years (mean age 38 years), were included. Fracture treatment was performed with kyphoplasty with balloon (Kyphon) and injection of calcium phosphate cement for a total of seven procedures.
The results were evaluated according to the regional kyphosis angle and the local kyphosis angle. The postoperative X-ray control showed an average improvement of the regional kyphosis angle of 7.4°; however, this value was reduced by an average of 6.6° after 45 days with regard to the postoperative control. The local kyphosis angle showed an average improvement of 9° at the postoperative control with an average worsening of 9.2° in the control after 45 days.
While kyphoplasty with the use of CPC in the treatment of type A traumatic fractures was effective in the treatment of pain, it has not been so far effective concerning the maintenance of the reduction obtained intra-operatively and its osteointegrative effect.
椎体成形术和最近的后凸成形术已被公认为治疗骨质疏松性椎体骨折的技术，并且在继发性肿瘤等病理性骨折的情况下也是如此。最近引入的磷酸钙骨水泥（CPC）至少在理论上具有聚甲基丙烯酸甲酯（PMMA）所缺乏的骨整合能力，因此引起了人们对其在治疗创伤性骨折（A型）中的应用的兴趣，甚至在年轻患者中也是如此。
本研究中，我们治疗了没有神经症状的 A 型骨折。共纳入 6 名男性患者，年龄在 21 至 55 岁之间（平均年龄 38 岁）。总共进行了 7 次球囊（Kyphon）椎体后凸成形术和磷酸钙骨水泥注射治疗。
根据区域性后凸角和局部后凸角评估结果。术后 X 射线检查显示，区域性后凸角平均改善 7.4°；然而，与术后即刻相比，术后 45 天时平均降低了 6.6°。局部后凸角术后即刻平均改善 9°，术后 45 天时平均恶化 9.2°。
虽然在治疗 A 型创伤性骨折时使用 CPC 进行后凸成形术在缓解疼痛方面有效，但到目前为止，它在维持术中获得的复位和骨整合效果方面并不有效。
