Denaro Vincenzo, Longo Umile Giuseppe, Maffulli Nicola, Denaro Luca
Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Rome, Italy.
Clin Cases Miner Bone Metab. 2009 May;6(2):125-30.
Vertebral fractures are a major health care problem in Western countries. Pain and deformity are the major problems related to these fractures, with an enormous impact on the quality of life. Surgery is indicated in patients with concurrent spinal instability or neurologic deficit. The cornerstone of management for vertebral body fractures without neurological impairment is medical therapy, which include analgesics, bed rest, orthoses and rehabilitation. In the majority of patients such treatment modalities are effective. However, conservative management measures are not indicated for every type of fracture. Two different percutaneous minimally invasive vertebral augmentation methods for cement application into the vertebral body in the management of symptomatic fractures without neurological impairment have been developed, namely vertebroplasty and kyphoplasty. Aim of this paper is to give an overview of the state of the art about vertebroplasty and kyphoplasty, discussing the indications, techniques, results and pitfalls.
椎体骨折在西方国家是一个重大的医疗保健问题。疼痛和畸形是与这些骨折相关的主要问题,对生活质量有巨大影响。对于并发脊柱不稳定或神经功能缺损的患者,需进行手术治疗。对于无神经损伤的椎体骨折,治疗的基石是药物治疗,包括使用镇痛药、卧床休息、佩戴矫形器及康复治疗。在大多数患者中,这些治疗方式是有效的。然而,并非每种骨折类型都适合采取保守治疗措施。目前已开发出两种不同的经皮微创椎体强化方法,即将骨水泥注入椎体以治疗无神经损伤的有症状骨折,分别是椎体成形术和后凸成形术。本文旨在概述椎体成形术和后凸成形术的最新进展,讨论其适应症、技术、治疗效果及存在的问题。