García-Maroto R, García-Coiradas J, Milano G, Cebrián J L, Marco F, López-Durán L
Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España.
Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España.
Rev Esp Cir Ortop Traumatol. 2015 Nov-Dec;59(6):406-12. doi: 10.1016/j.recot.2015.05.003. Epub 2015 Jun 20.
Vertebral fractures in oncology patients cause significant pain and disability, with decreased quality of life. The aim of the study is to assess the efficacy and safety of kyphoplasty in this type of vertebral fracture in the acute phase.
A retrospective study was conducted on 75 consecutive oncology patients with 122 acute vertebral fractures, who underwent bilateral balloon kyphoplasty, with a mean follow up of 11 months.
Almost all (91%) of the patients improved their pain level. The mean improvement in the Visual Analogue Scale (VAS) was 4.28 points (preoperative value 7.49 [SD 1.19], postoperative 3.21 [SD 0.95]). Before surgery, 53% of patients needed major opioids (40 cases), and one month after surgery only 12% (9 patients) required them. Quality of life determined by the Karnofsky index improved from 60.2 (SD 10) to 80.7 (SD 12.1). Cement leaks were found in 5.7% (7 cases), all without neurological repercussions. New fractures appeared in 11 patients. This subgroup showed a slight worsening of the initially acquired clinical improvement. No neurological or pulmonary complications related to surgical technique were found.
Kyphoplasty is an effective and safe for treating vertebral fractures in patients with cancer.
Level IV.
肿瘤患者的椎体骨折会导致严重疼痛和残疾，生活质量下降。本研究的目的是评估后凸成形术在急性期此类椎体骨折中的疗效和安全性。
对75例连续的肿瘤患者进行回顾性研究，这些患者有122处急性椎体骨折，均接受了双侧球囊后凸成形术，平均随访11个月。
几乎所有（91%）患者的疼痛程度都有所改善。视觉模拟评分（VAS）的平均改善为4.28分（术前值7.49[标准差1.19]，术后3.21[标准差0.95]）。术前，53%的患者需要大剂量阿片类药物（40例），术后1个月只有12%（9例）患者需要。由卡诺夫斯基指数确定的生活质量从60.2（标准差10）提高到80.7（标准差12.1）。发现5.7%（7例）有骨水泥渗漏，均无神经方面的影响。11例患者出现新的骨折。该亚组最初获得的临床改善略有恶化。未发现与手术技术相关的神经或肺部并发症。
后凸成形术治疗癌症患者的椎体骨折有效且安全。
四级。
