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椎体成形术与后凸成形术治疗骨质疏松性椎体压缩骨折的对比分析

Comparative analysis of vertebroplasty and kyphoplasty for osteoporotic vertebral compression fractures.

作者信息

Bozkurt Melih, Kahilogullari Gokmen, Ozdemir Mevci, Ozgural Onur, Attar Ayhan, Caglar Sukru, Ates Can

机构信息

Department of Neurosurgery, Ankara University School of Medicine, Ankara, Turkey.

Department of Neurosurgery, Pamukkale University School of Medicine, Denizli, Turkey.

出版信息

Asian Spine J. 2014 Feb;8(1):27-34. doi: 10.4184/asj.2014.8.1.27. Epub 2014 Feb 6.

Abstract

STUDY DESIGN

A retrospective study.

PURPOSE

The aim of this study is to compare the efficacy and outcome of vertebroplasty compared with unipedicular and bipedicular kyphoplasty for the treatment of osteoporotic vertebral compression fractures in terms of pain, functional capacity and height restoration rates.

OVERVIEW OF LITERATURE

The vertebroplasty procedure was first performed in 1984 for the treatment of a hemangioma at the C2 vertebra. Kyphoplasty was first performed in 1998 and includes vertebral height restoration in addition to using inflation balloons and high-viscosity cement. Both are efficacious, safe and long-lasting procedures. However, controversy still exists about pain relief, improvement in functional capacity, quality of life and height restoration the superiority of these procedures and assessment of appropriate and specific indications of one over the other remains undefined.

METHODS

Between 2004 and 2011, 296 patients suffering from osteoporotic vertebral compression fracture underwent 433 vertebroplasty and kyphoplasty procedures. Visual analogue scale (VAS), the Oswestry Disability Index (ODI) and height restoration rates were used to evaluate the results.

RESULTS

Mean height restoration rate was 24.16%±1.27% in the vertebroplasty group, 24.25%±1.28% in the unipedicular kyphoplasty group and 37.05%±1.21% in the bipedicular kyphoplasty group. VAS and ODI scores improved all of the groups.

CONCLUSIONS

Vertebroplasty and kyphoplasty are both effective in providing pain relief and improvement in functional capacity and quality of life after the procedure, but the bipedicular kyphoplasty procedure has a further advantage in terms of height restoration when compared to unipedicular kyphoplasty and vertebroplasty procedures.

摘要

研究设计

一项回顾性研究。

目的

本研究旨在比较椎体成形术与单侧和双侧后凸成形术在治疗骨质疏松性椎体压缩骨折方面的疗效和结果,包括疼痛、功能能力和身高恢复率。

文献综述

椎体成形术于1984年首次用于治疗C2椎体血管瘤。后凸成形术于1998年首次实施,除使用膨胀球囊和高粘度骨水泥外,还包括恢复椎体高度。两者都是有效、安全且持久的手术。然而,在疼痛缓解、功能能力改善、生活质量和身高恢复方面仍存在争议,这些手术的优越性以及一种手术相对于另一种手术的适当和特定适应症的评估仍不明确。

方法

2004年至2011年期间,296例骨质疏松性椎体压缩骨折患者接受了433例椎体成形术和后凸成形术。使用视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)和身高恢复率来评估结果。

结果

椎体成形术组的平均身高恢复率为24.16%±1.27%,单侧后凸成形术组为24.25%±1.28%,双侧后凸成形术组为37.05%±1.21%。所有组的VAS和ODI评分均有所改善。

结论

椎体成形术和后凸成形术在术后缓解疼痛、改善功能能力和生活质量方面均有效,但与单侧后凸成形术和椎体成形术相比,双侧后凸成形术在身高恢复方面具有进一步的优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18bc/3939366/213406c62867/asj-8-27-g001.jpg

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