Yaltirik Kaan, Ashour Ahmed M, Reis Conner R, Özdoğan Selçuk, Atalay Başar
Department of Neurosurgery, School of Medicine, Yeditepe University, Istanbul, Turkey.
Department of Neurosurgery, Saint Louis University, Saint Louis, MO, USA.
J Craniovertebr Junction Spine. 2016 Jul-Sep;7(3):153-60. doi: 10.4103/0974-8237.188413.
Minimally invasive percutaneous vertebral augmentation techniques; vertebroplasty, and kyphoplasty have been treatment choices for vertebral compression fractures (VCFs). The purpose of this study is to evaluate the outcomes of the patients who underwent vertebroplasty or kyphoplasty regarding complications, correction of vertebral body height, kyphosis angle and pain relief assessment using visual analog score (VAS) for pain.
A retrospective review of the hospital records for 100 consecutive patients treated with kyphoplasty or vertebroplasty in our department database. Patients with osteoporotic compression fractures, traumatic compressions, and osteolytic vertebral lesions, including metastases, hemangiomas, and multiple myeloma, were included in the study. Preoperative and postoperative VAS pain scores, percentages of vertebral compression and kyphotic angles were measured and compared as well as demographic characteristics and postoperative complications. Mobilization and length of stay (LOS) were recorded.
One hundred patients were treated by 110 procedures. 64 patients were operated on due to osteoporosis (72 procedures). Twelve patients were operated on because of metastasis (13 procedures), 8 patients were operated on because of multiple myeloma (9 procedures). Five patients had two surgeries, 1 patient had 3 surgeries, and 1 patient had 5 surgeries. The mean preoperative VAS was 74.05 ± 9.8. In total, 175 levels were treated, 46 levels by kyphoplasty and 129 by vertebroplasty. The mean postoperative VAS was 20.94 ± 11.8. Most of the patients were mobilized in the same day they of surgery. Mean LOS was 1.83 days. Six patients had nonsymptomatic leakage of polymethlymethacrylate, and patient had epidural hematoma, which was operated on performing hemi-laminectomy.
Percutaneous vertebroplasty and balloon kyphoplasty are both effective and safe minimally invasive procedures for the stabilization of VCFs. However, complications should be kept in mind during decision making.
微创经皮椎体强化技术，即椎体成形术和后凸成形术，一直是椎体压缩骨折（VCF）的治疗选择。本研究的目的是评估接受椎体成形术或后凸成形术患者在并发症、椎体高度矫正、后凸角以及使用视觉模拟评分（VAS）评估疼痛缓解方面的结果。
回顾性分析我们科室数据库中连续100例接受后凸成形术或椎体成形术治疗患者的医院记录。研究纳入骨质疏松性压缩骨折、创伤性压缩骨折以及溶骨性椎体病变（包括转移瘤、血管瘤和多发性骨髓瘤）患者。测量并比较术前和术后的VAS疼痛评分、椎体压缩百分比和后凸角，以及人口统计学特征和术后并发症。记录活动情况和住院时间（LOS）。
100例患者接受了110次手术。64例患者因骨质疏松接受手术（72次手术）。12例患者因转移瘤接受手术（13次手术），8例患者因多发性骨髓瘤接受手术（9次手术）。5例患者接受了两次手术，1例患者接受了3次手术，1例患者接受了5次手术。术前平均VAS为74.05±9.8。总共治疗了175个节段，46个节段采用后凸成形术，129个节段采用椎体成形术。术后平均VAS为20.94±11.8。大多数患者在手术当天即可活动。平均住院时间为1.83天。6例患者出现聚甲基丙烯酸甲酯无症状渗漏，1例患者出现硬膜外血肿，接受了半椎板切除术。
经皮椎体成形术和球囊后凸成形术都是稳定VCF的有效且安全的微创手术。然而，在决策过程中应牢记并发症。
