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经皮椎体后凸成形术治疗胸腰椎创伤性压缩性骨折的中期临床和影像学结果。

Mid-Term Clinical and Radiological Outcomes After Kyphoplasty in the Treatment of Thoracolumbar Traumatic Vertebral Compression Fractures.

机构信息

Department of Neurosurgery, Dijon University Hospital, Dijon, France.

Department of Neurosurgery, Dijon University Hospital, Dijon, France.

出版信息

World Neurosurg. 2018 Jul;115:e386-e392. doi: 10.1016/j.wneu.2018.04.060. Epub 2018 Apr 17.

Abstract

BACKGROUND

The management of thoracolumbar posttraumatic compression fractures varies widely among centers, and there is no real consensus as to the optimum approach. The objective of our retrospective study was to detect the progression of vertebral kyphosis in nonosteoporotic patients treated by balloon kyphoplasty (KPB) who presented with recent compression fractures of the thoracolumbar region.

METHODS

In this retrospective study, we investigated the evolution of vertebral and regional kyphosis in 77 patients treated by KPB for compression vertebral fractures (Magerl A) between 2007 and 2011. All treated patients, even those lost to follow-up, were included in our statistical analysis.

RESULTS

In the 77 patients, a 2.4° deterioration of vertebral kyphosis (P = 0.0004) and a 4.5° worsening of regional kyphosis (P < 0.0001) were observed at the end of the follow-up period. No statistical correlation between the worsened kyphosis and the deterioration of long-term pain was identified. The mean visual analog scale score was 2.5, associated with very low disability on functional scores. A3-2 and A3-3 fractures are characterized by worsening vertebral and regional kyphosis.

CONCLUSIONS

The paucity of studies of posttraumatic vertebral compression fractures in the scientific literature explains the lack of consensus regarding the optimum treatment approach. Postoperative results with KPB favor vertebral and regional kyphosis stability. KPB remains indicated in this situation except in cases of for burst fracture.

摘要

背景

胸腰椎创伤后压缩性骨折的治疗方法在各中心之间差异很大,对于最佳治疗方法也没有达成真正的共识。我们的回顾性研究旨在检测非骨质疏松症患者经球囊扩张椎体后凸成形术(KPB)治疗后近期胸腰椎压缩性骨折的椎体后凸畸形进展情况。

方法

在这项回顾性研究中,我们调查了 77 例因压缩性椎体骨折(Magerl A 型)于 2007 年至 2011 年接受 KPB 治疗的患者的椎体和区域后凸畸形的演变情况。所有接受治疗的患者,即使是失访患者,均纳入我们的统计分析。

结果

在 77 例患者中,在随访期末观察到椎体后凸角恶化 2.4°(P=0.0004),区域后凸角恶化 4.5°(P<0.0001)。未发现恶化的后凸角与长期疼痛恶化之间存在统计学相关性。平均视觉模拟评分(VAS)为 2.5,功能评分显示残疾程度非常低。A3-2 和 A3-3 骨折的特点是椎体和区域后凸角恶化。

结论

创伤性椎体压缩性骨折的研究在科学文献中相对较少,这解释了对于最佳治疗方法缺乏共识的原因。KPB 术后结果有利于椎体和区域后凸角的稳定性。除爆裂骨折外,KPB 在这种情况下仍然适用。

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