Ng Jonathan P, Cawley Derek T, Beecher Suzanne M, Baker Joseph F, McCabe John P
Department of Orthopaedic and Traumatology, Galway University Hospital, Republic of Ireland.
Int J Spine Surg. 2016 May 18;10:21. doi: 10.14444/3021. eCollection 2016.
Standard positioning for percutaneous balloon kyphoplasty requires placing a patient prone with supports under the iliac crests and upper thorax. The authors believe that hip hyperextension maximises pelvic anteversion creating anterior longitudinal ligamentotaxis, thus facilitating restoration of vertebral height.
Radiographic imaging including pre-operative, post-positioning, post balloon tamp inflation and post-operative lateral radiographs were analysed for anterior and posterior column height, wedge angle of the affected vertebra and 3-level Cobb angle in patients with recent fractures of T11-L1. Fracture dimensions of the index vertebra were expressed as percentage of the analogous dimension of the referent vertebra.
From a total of 149 patients, a full imaging sequence was available on 21 cases of vertebral compression fractures. The described positioning technique created a mean anterior column height increase from 68.3% to 75.3% with positioning (p = 0.15), increasing to 82.3% post balloon inflation. Average Cobb and wedge angle improvement of 4.7° (p = 0.004)and 3.6° (p = 0.002) from positioning along were also recorded.
The Reverse Thomas Position is a safe and effective technique for augmenting thoracolumbar fracture height restoration in percutaneous balloon kyphoplasty.
经皮球囊后凸成形术的标准体位要求患者俯卧，在髂嵴和上胸部下方放置支撑物。作者认为，髋关节过伸可使骨盆前倾最大化，从而产生前纵韧带牵张，有助于恢复椎体高度。
对11 - 1节段近期骨折患者的术前、体位摆放后、球囊扩张后及术后的侧位X线片进行影像学分析，测量伤椎的前柱和后柱高度、楔角以及3节段Cobb角。伤椎的骨折尺寸以参照椎体相应尺寸的百分比表示。
在总共149例患者中，21例椎体压缩骨折患者有完整的影像序列。所述的体位摆放技术使前柱高度在体位摆放后平均从68.3%增加到75.3%（p = 0.15），球囊扩张后增加到82.3%。同时记录到从体位摆放开始，平均Cobb角和楔角分别改善了4.7°（p = 0.004）和3.6°（p = 0.002）。
反向托马斯体位是一种安全有效的技术，可在经皮球囊后凸成形术中增加胸腰椎骨折高度的恢复。
