Department of Neurosurgery, Baskent University, Istanbul Research Hospital, Istanbul, Turkey.
Department of Neurosurgery, University of Health Sciences, Konya Education and Training Hospital, Konya, Turkey.
Med Sci Monit. 2018 Apr 10;24:2142-2148. doi: 10.12659/msm.909169.
BACKGROUND Vertebral compression fracture is common in osteoporosis, but can also occur due to bone metastases, for which current treatment options are limited and include bone-strengthening with cement and supportive care. Kyphoplasty is a surgical method of bone augmentation that can reduce pain, stabilize vertebral bone, and restore some or all of the vertebral body height. The aim of this study was to investigate the clinical results of balloon kyphoplasty in the correction of vertebral deformity due to metastatic vertebral compression fracture. MATERIAL AND METHODS A retrospective clinical study included 72 patients (82 vertebral bodies) with metastases resulting in vertebral compression fracture, treated by percutaneous balloon kyphoplasty; 9 patients were found incidentally to have vertebral metastases. Bone mineral density (BMD) levels were measured. Patient responses from questionnaires, including the visual analog scale (VAS) for pain intensity, and the Oswestry Disability Index (ODI) for disability, were scored. The local kyphosis angle (KA) and the vertebral height ratio (VHR) were measured. All patients were followed up for 12 months. The initial postoperative and 12-month postoperative values, and the preoperative and postoperative values were compared. RESULTS Following balloon kyphoplasty, the KA, VHR, VAS, and ODI scores significantly improved at the final 12-month follow-up compared with preoperative levels (p<0.05, and p<0.001). There was cement leakage in 6 procedures (8.3%) and adjacent segment fracture in 11 procedures (15.2%). CONCLUSIONS Balloon kyphoplasty was an effective method to reduce pain, reduce disability, and improve quality of life by eliminating kyphotic deformity in pathological vertebral compression fractures due to vertebral metastases.
骨质疏松症常导致椎体压缩性骨折,但也可由骨转移引起,目前的治疗选择有限,包括用骨水泥强化和支持性治疗。球囊椎体后凸成形术是一种增强骨质的手术方法,可减轻疼痛、稳定椎体骨骼,并恢复部分或全部椎体高度。本研究旨在探讨球囊椎体后凸成形术矫正转移性椎体压缩性骨折所致椎体畸形的临床效果。
回顾性临床研究纳入 72 例(82 个椎体)因转移性椎体压缩性骨折而行经皮球囊椎体后凸成形术治疗的患者;9 例患者偶然发现有椎体转移。测量骨密度(BMD)水平。通过问卷调查评估患者的反应,包括疼痛强度的视觉模拟量表(VAS)评分和残疾的 Oswestry 功能障碍指数(ODI)评分。测量局部后凸角(KA)和椎体高度比(VHR)。所有患者均随访 12 个月。比较初始术后和 12 个月后的随访值,以及术前和术后的值。
球囊椎体后凸成形术后,在最终 12 个月随访时,KA、VHR、VAS 和 ODI 评分均较术前显著改善(p<0.05 和 p<0.001)。6 例(8.3%)发生水泥渗漏,11 例(15.2%)发生相邻节段骨折。
球囊椎体后凸成形术是一种有效的方法,可通过消除病理性椎体压缩性骨折所致的后凸畸形来减轻疼痛、降低残疾程度和改善生活质量。