Masala S, Calabria E, Nano G, Iundusi R, Greco L, Di Trapano R, Tarantino U, Simonetti G
Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology, and Radiation Therapy, University Hospital Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
Case Rep Orthop. 2013;2013:613149. doi: 10.1155/2013/613149. Epub 2013 Aug 1.
In November 2011 a 75-year-old man was admitted to our emergency department with a low back pain caused by a traumatic L1 vertebral collapse with backward projection of posterior wall superior third. The indication for neurosurgical instrumentation was placed, although he refused the treatment. Hence he was treated conservatively without a significant improvement up to January 2012 when, still refusing surgery, he accepted to undergo percutaneous vertebroplasty with a novel bioactive injectable strontium-hydroxyapatite cement. Vertebroplasty was performed without complications. A CT scan, performed the day after the procedure, ruled out extravertebral cement leakage. Pain improvement was significant (preprocedure VAS 10, one-week VAS 4) with a gradual decrease up to three months when it stabilized at 2. CT examination after 1 year showed a good cement osseointegration with osteophytic spurs bridging the superior endplate of the level involved to the inferior one of the level above. The new bone ingrowing property of the strontium-hydroxyapatite containing cement permits to extend the treatment indication also to unstable collapses in which the risk of pseudoarthrosis is very high. In this reported case we evaluated the potential role of percutaneous vertebroplasty in traumatic burst fracture with spinal channel involvement.
2011年11月，一名75岁男性因L1椎体创伤性塌陷伴后壁上三分之一向后突出导致的腰痛被收入我院急诊科。尽管他拒绝治疗，但仍有进行神经外科器械治疗的指征。因此，他接受了保守治疗，但直到2012年1月仍无明显改善，当时他仍拒绝手术，但接受了使用新型生物活性可注射锶羟基磷灰石骨水泥进行的经皮椎体成形术。椎体成形术顺利完成，无并发症。术后第二天进行的CT扫描排除了椎体外骨水泥渗漏。疼痛改善显著（术前视觉模拟评分[VAS]为10分，一周后为4分），直至三个月时逐渐下降并稳定在2分。1年后的CT检查显示骨水泥与骨整合良好，有骨赘将受累节段的上终板与上方节段的下终板连接起来。含锶羟基磷灰石的骨水泥的新骨生长特性使得治疗指征也可扩展至假关节形成风险非常高的不稳定塌陷。在本报告的病例中，我们评估了经皮椎体成形术在伴有椎管受累的创伤性爆裂骨折中的潜在作用。
