Lamanna Anthony, Maingard Julian, Kok Hong Kuan, Ranatunga Dinesh, Looby Seamus T, Brennan Paul, Chua Michelle, Owen Andrew, Brooks Duncan Mark, Chandra Ronil V, Asadi Hamed
Interventional Radiology Service - Department of Radiology, Austin Hospital, Melbourne, Victoria, Australia.
Department of Imaging, Monash Health, Melbourne, Victoria, Australia.
J Med Imaging Radiat Oncol. 2019 Dec;63(6):779-785. doi: 10.1111/1754-9485.12900. Epub 2019 May 20.
Vertebral compression fractures (VCFs) are a common cause of back pain and disability and are usually osteoporotic in nature. Therapy aims to adequately control pain and allow early mobilisation and return of function while preventing additional fractures. A proportion of patients do not achieve adequate pain relief using conservative measures alone. Unwanted adverse effects from medications may also ensue. Vertebroplasty represents an alternative treatment option for VCFs. Patients with acute VCFs (≤6 weeks old) may gain the most benefit from vertebroplasty as healed fractures are not as amenable to cement injection. High-quality studies have reported conflicting results regarding the use of vertebroplasty in the treatment of acute VCFs. Despite high-quality evidence, varying study designs and heterogenous patient cohorts make interpretation of this data difficult. Only one sham-controlled randomised controlled trial (RCT) has evaluated vertebroplasty exclusively in patients with acute VCFs, reporting favourable results. Pooled data from RCTs also suggest vertebroplasty to be safe. This article provides a concise and critical review of the current literature regarding vertebroplasty for the treatment of acute VCFs.
椎体压缩性骨折（VCF）是背痛和残疾的常见原因，其本质通常为骨质疏松性。治疗旨在充分控制疼痛，使患者能够早期活动并恢复功能，同时预防再次骨折。一部分患者仅采用保守措施无法实现充分的疼痛缓解。药物治疗还可能产生不良副作用。椎体成形术是VCF的一种替代治疗选择。急性VCF（≤6周龄）患者可能从椎体成形术中获益最大，因为愈合的骨折不太适合注入骨水泥。关于椎体成形术治疗急性VCF的应用，高质量研究报告的结果相互矛盾。尽管有高质量证据，但不同的研究设计和异质性患者队列使得对这些数据的解读变得困难。仅有一项假手术对照随机对照试验（RCT）专门评估了急性VCF患者的椎体成形术，报告结果良好。RCT的汇总数据也表明椎体成形术是安全的。本文对目前有关椎体成形术治疗急性VCF的文献进行了简要而批判性的综述。
