Department of Orthopaedic Surgery, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
Department of Orthopaedic Surgery, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
Spine J. 2018 Jun;18(6):962-969. doi: 10.1016/j.spinee.2017.10.006. Epub 2017 Oct 18.
Controversy exists regarding percutaneous balloon kyphoplasty (PBK) in patients with a very severe osteoporotic vertebral compression fracture (vsOVCF).
The study was conducted to investigate the clinical and radiological outcomes of PBK for the treatment of vsOVCF compared with those of non-vsOVCF.
STUDY DESIGN/SETTING: This is a retrospective, case-control study.
A total of 167 consecutive patients (210 vertebral bodies) who underwent PBK for OVCF between March 2010 and January 2015 were assessed.
Visual analog scale (VAS) scores for back pain, Korean Oswestry disability index (K-ODI) scores, vertebral body height variations, and kyphotic angles were evaluated preoperatively, postoperatively, and 1 year after treatment.
Patients in the non-vsOVCF group (anterior vertebral compression of more than two-thirds on plain radiograph) who had undergone PBK where compared with those in the non-vsOVCF group (compression between 30% and two-thirds). Clinical and radiological outcomes were compared. In addition, complications were evaluated.
In total, 31 patients (33 vertebrae) in the vsOVCF group and 136 patients (177 vertebrae) in the non-vsOVCF group were treated with PBK. Both groups had significant postoperative improvements in the clinical and radiological outcomes (VAS score, K-ODI score, vertebral body height variation, and kyphotic angle). There was no difference regarding the VAS score and the K-ODI score between the two groups at the final follow-up (p>.05). The cement leakage occurred frequently in the vsOVCF group (26 vertebrae, 78.8%) than in the non-vsOVCF group (92 vertebrae, 52.0%), the difference was statistically significant (p<.05). But there was no case that showed neurologic complication or pulmonary embolism caused by cement leakage. The incidence of recollapse was significantly higher in the vsOVCF group (five vertebrae, 15.2%) than in the non-vsOVCF group (seven vertebrae, 4.0%) (p<.05). The incidence of an adjacent segment fracture (vsOVCF group, 6 vertebrae, 18.2%; non-vsOVCF group, 21 vertebrae, 11.9%) was not significantly different (p=.320).
Percutaneous balloon kyphoplasty is a safe and effective procedure for the treatment of vsOVCF.
对于患有非常严重骨质疏松性椎体压缩性骨折（vsOVCF）的患者，经皮球囊椎体后凸成形术（PBK）存在争议。
本研究旨在探讨 PBK 治疗 vsOVCF 与非 vsOVCF 的临床和影像学结果。
研究设计/设置：这是一项回顾性病例对照研究。
2010 年 3 月至 2015 年 1 月期间，共评估了 167 例连续接受 PBK 治疗 OVCF 的患者（210 个椎体）。
术前、术后和治疗后 1 年评估腰痛的视觉模拟评分（VAS）、韩国 Oswestry 残疾指数（K-ODI）评分、椎体高度变化和后凸角。
比较 PBK 治疗的非 vsOVCF 组（平片上的前椎体压缩超过三分之二）与非 vsOVCF 组（压缩在 30%到三分之二之间）的患者。比较临床和影像学结果。此外，还评估了并发症。
共 31 例（33 个椎体）vsOVCF 组和 136 例（177 个椎体）非 vsOVCF 组接受 PBK 治疗。两组在临床和影像学结果（VAS 评分、K-ODI 评分、椎体高度变化和后凸角）方面均有显著的术后改善。在最终随访时，两组的 VAS 评分和 K-ODI 评分无差异（p>.05）。vsOVCF 组（26 个椎体，78.8%）比非 vsOVCF 组（92 个椎体，52.0%）的骨水泥渗漏更常见，差异有统计学意义（p<.05）。但无因骨水泥渗漏引起的神经并发症或肺栓塞病例。vsOVCF 组（5 个椎体，15.2%）的再塌陷发生率明显高于非 vsOVCF 组（7 个椎体，4.0%）（p<.05）。相邻节段骨折的发生率（vsOVCF 组，6 个椎体，18.2%；非 vsOVCF 组，21 个椎体，11.9%）无显著差异（p=.320）。
经皮球囊椎体后凸成形术是治疗 vsOVCF 的一种安全有效的方法。
