Markmiller Max
OCKA, Vincentinum Hospital, Franziskanergasse 14, 86152, Augsburg, Germany.
Eur Spine J. 2015 Oct;24(10):2165-72. doi: 10.1007/s00586-014-3751-7. Epub 2015 Jan 8.
To evaluate the benefits of minimally invasive balloon kyphoplasty (BKP) in patients with cancer and painful pathologic vertebral lesions.
In this longitudinal, prospective, consecutive study, patients received BKP at one or more vertebral levels. The BKP procedure was guided by computed tomographic fluoroscopy. Orthopaedic bone tamps were inflated to create a cavity and the fracture was stabilised using viscous polymethylmethacrylate bone cement. After the procedure, early mobilisation was encouraged.
Overall, 115 patients (52.2% with vertebral fractures) received BKP. The majority (82.6%) of patients received BKP as a stand-alone procedure. BKP treatment provided significant (P<0.0001) improvements in Visual Analogue Scale (VAS)-pain (median change: -4), Oswestry Disability Index (ODI; mean change: -53.2), and Karnofsky Performance Status (KPS; median change: 15) scores at 6 and 12 months. In total, 23% of patients achieved increased vertebral height (7.4% mean improvement in angle index). The presence of height restoration and the number of levels treated did not affect VAS or ODI scores; improvements in KPS scores were numerically higher in patients who received BKP plus additional surgery (15-20) compared with stand-alone BKP (10-15). Mean hospital times were 7.2±6.5 days. The majority (97.4%) of patients showed no complications related to the procedure; three patients (2.6%) had a temporary radiculopathy. Incidences of cement leakage were observed in 40 patients (34.8%).
Minimally invasive BKP provided excellent long-term palliation of pain and improved mobility in patients with cancer and painful osteolytic spinal lesions or vertebral fractures.
评估微创球囊椎体后凸成形术（BKP）对患有癌症且伴有疼痛性病理性椎体病变患者的益处。
在这项纵向、前瞻性、连续性研究中，患者在一个或多个椎体节段接受了BKP。BKP手术由计算机断层扫描荧光透视引导。使用矫形骨填充器充气以形成一个腔隙，并使用粘性聚甲基丙烯酸甲酯骨水泥稳定骨折。手术后，鼓励早期活动。
总体而言，115例患者（52.2%有椎体骨折）接受了BKP。大多数（82.6%）患者接受BKP作为单独手术。BKP治疗在6个月和12个月时，视觉模拟量表（VAS）疼痛评分（中位数变化：-4）、奥斯威斯功能障碍指数（ODI；平均变化：-53.2）和卡氏功能状态评分（KPS；中位数变化：15）有显著（P<0.0001）改善。共有23%的患者椎体高度增加（角度指数平均改善7.4%）。椎体高度恢复情况和治疗的节段数量不影响VAS或ODI评分；接受BKP加额外手术（15 - 20个节段）的患者KPS评分改善在数值上高于单独接受BKP（10 - 15个节段）的患者。平均住院时间为7.2±6.5天。大多数（97.4%）患者未出现与手术相关的并发症；3例患者（2.6%）出现了临时性神经根病。40例患者（34.8%）观察到骨水泥渗漏情况。
微创BKP为患有癌症且伴有疼痛性溶骨性脊柱病变或椎体骨折的患者提供了出色的长期疼痛缓解并改善了活动能力。
