Clarençon Frédéric, Fahed Robert, Gabrieli Joseph, Guermazi Yessine, Cormier Evelyne, Molet-Benhamou Luc, Jean Betty, Dadoun Sabrina, Rose Michèle, Le Jean Lise, Chiras Jacques
Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
Paris VI University Pierre et Maris Curie, Paris, France.
Eur Radiol. 2016 Jul;26(7):2352-8. doi: 10.1007/s00330-015-4035-2. Epub 2015 Oct 1.
To evaluate the safety and clinical effectiveness of percutaneous vertebroplasty (PVP) in patients aged 80 and over.
One hundred and seventy-three patients (127 women, 46 men; mean age = 84.2y) underwent 201 PVP procedures (391 vertebrae) in our institution from June 2008 to March 2012. One hundred and twenty-six patients (73 %) had osteoporotic vertebral compression fractures (VCF), 36 (20.5 %) were treated for tumour lesions, and the remaining 11 (6.5 %) for lesions from another cause. Comorbidities and American Society of Anesthesiologists (ASA) scores were assessed before treatment. Periprocedural and delayed complications were systematically recorded. A qualitative scale was used to evaluate pain relief at 1-month follow-up, ranging from significant pain worsening to marked improvement or disappearance. New fracture occurrence was assessed on follow-up imaging.
Forty-five percent of patients had pretreatment ASA class scores ≥3. No major complication occurred. Pain was unchanged in 16.9 % of cases, mildly improved in 31.5 %, and disappeared in 47.8 %. We identified 27 (11 %) symptomatic new VCFs in patients with osteoporosis on follow-up imaging. The mean delay in diagnosis of new fractures was 5 ± 8.7 months.
Even in the elderly, PVP remains a safe and effective technique for pain relief, independently of the underlying disease.
• Post-PVP pain improvement was observed in 79.3 % of elderly patients. • PVP remains a safe technique in elderly patients. • No decompensation of comorbidity was observed in our series.
评估经皮椎体成形术（PVP）在80岁及以上患者中的安全性和临床有效性。
2008年6月至2012年3月，我院173例患者（127例女性，46例男性；平均年龄84.2岁）接受了201次PVP手术（391个椎体）。126例患者（73%）患有骨质疏松性椎体压缩骨折（VCF），36例（20.5%）接受肿瘤病变治疗，其余11例（6.5%）因其他原因导致的病变接受治疗。治疗前评估合并症和美国麻醉医师协会（ASA）评分。系统记录围手术期和延迟并发症。采用定性量表在1个月随访时评估疼痛缓解情况，范围从疼痛明显加重到明显改善或消失。在随访影像学检查中评估新骨折的发生情况。
45%的患者术前ASA分级评分≥3。未发生重大并发症。16.9%的病例疼痛无变化，31.5%轻度改善，47.8%消失。在随访影像学检查中，我们在骨质疏松患者中发现27例（11%）有症状的新VCF。新骨折诊断的平均延迟时间为5±8.7个月。
即使在老年人中，PVP仍然是一种安全有效的缓解疼痛的技术，与潜在疾病无关。
•79.3%的老年患者PVP术后疼痛得到改善。•PVP在老年患者中仍然是一种安全的技术。•在我们的系列研究中未观察到合并症失代偿情况。
