Mauri Giovanni, Nicosia Luca, Sconfienza Luca Maria, Varano Gianluca Maria, Vigna Paolo Della, Bonomo Guido, Orsi Franco, Anselmetti Giovanni Carlo
Department of Interventional Radiology, European Institute of Oncology, 20141, Milan, Italy.
Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Facoltà di Medicina e Chirurgia, via Festa del Perdono, 7, 20122, Milan, Italy.
Eur Radiol Exp. 2018 Oct 24;2(1):31. doi: 10.1186/s41747-018-0062-5.
Image-guided elastoplasty is an innovative method for percutaneous vertebral augmentation with a silicone elastomeric material. Our aim was to evaluate its technical success, safety and efficacy as well as the rate of secondary fractures.
Nineteen patients (13 women and 6 men, age 72 ± 10 years, mean ± standard deviation) underwent elastoplasty between 2010 and 2016. A total of 33 vertebrae were treated. A total of 2-6 mL of silicone-based elastomeric polymer material (VK100) was used. Visual analogue scale (VAS) and Oswestry disability index (ODI) pain scores were used.
In all cases, it was possible to complete the procedure (technical success 100%). No major complications occurred. In 6/19 (31.5%) patients, asymptomatic leakage of the material was observed during the procedure. Full pain recovery was obtained in 18/19 (94%) patients. One patient with a painful angioma did not experience any change in symptoms. VAS and ODI were significantly reduced after the procedure, from 7.9 ± 1.1 to 0.7 ± 1.4 and from 79.6 ± 12% to 9.9 ± 14% respectively (p < 0.001 for both comparisons). After vertebroplasty, 14 of 15 patients (93%) removed the brace and 16/19 (84%) completely stopped using any drugs for pain relief (p < 0.001 for both pre-procedure versus post-procedure comparisons). At a mean follow-up time of 26.5 ± 28.1 months (median 8.7 months, range 6-69 months), no secondary fracture occurred.
Taking into consideration the relatively small sample size, image-guided elastoplasty seems to be a safe procedure providing effective pain control over time.
图像引导下弹性体成形术是一种采用硅酮弹性体材料进行经皮椎体强化的创新方法。我们的目的是评估其技术成功率、安全性和有效性以及二次骨折发生率。
2010年至2016年间，19例患者（13例女性和6例男性，年龄72±10岁，均值±标准差）接受了弹性体成形术。共治疗33个椎体。总共使用了2 - 6毫升硅酮基弹性体聚合物材料（VK100）。采用视觉模拟评分法（VAS）和奥斯威斯利功能障碍指数（ODI）疼痛评分。
所有病例均成功完成手术（技术成功率100%）。未发生重大并发症。在6/19（31.5%）的患者中，术中观察到材料无症状性渗漏。18/19（94%）的患者疼痛完全缓解。1例患有疼痛性血管瘤的患者症状无任何变化。术后VAS和ODI显著降低，分别从7.9±1.1降至0.7±1.4，从79.6±12%降至9.9±14%（两组比较p均<0.001）。椎体成形术后，15例患者中的14例（93%）拆除了支具，16/19（84%）的患者完全停止使用任何止痛药物（术前与术后比较，两组p均<0.001）。平均随访时间为26.5±28.1个月（中位数8.7个月，范围6 - 69个月），未发生二次骨折。
考虑到样本量相对较小，图像引导下弹性体成形术似乎是一种安全的手术方法，能长期有效控制疼痛。
