Ahsan Md Kamrul, Pandit Om Prakash, Khan Md Shahidul Islam
Department Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh.
Surg Neurol Int. 2021 Apr 19;12:176. doi: 10.25259/SNI_212_2021. eCollection 2021.
Osteoporotic vertebral compression fractures (OVCFs) increasingly occur with advancing age, and are associated with significant morbidity, mortality, and cost. We assessed the clinical efficacy, radiological, and functional outcomes for patients undergoing percutaneous vertebroplasty (PVP) due to OVCFs, with a special focus on the frequency of new vertebral compression fractures (VCFs).
This study, carried from 2018 to 2020, included 22 females and 4 males. They averaged 60.15 years of age (range, 50-70) were followed an average of 14.5 months (range 12-36 months), and had 30 VCFs between the T7-L2 levels. Multiple variables were studied, including; anterior vertebral height (AVH) and kyphotic angle (KA), new VCFs, and functional outcomes.
The postoperative Visual Analog Scale and Oswestry Disability Index were significantly reduced at 12 months after PVP. Improvements for AVH and KA were also statistically significant; 23 patients (88.46%) had a dramatic decrease in pain on post-operative day 1, while 3 patients (11.53%) had no decrease in pain after PVP on post-operative day 1-1 postoperative month. No major complications were observed except high incidence of cement leakage at 8 levels (26.67%) in 6 patients. Additionally, new VCFs occurred in 10 vertebrae in 8 patients (30.76%), involving 6 adjacent (60%), and 4 nonadjacent vertebrae (40%).
PVP is an effective procedure in the management of painful OVCFs refractory to medical treatment. These PVP procedures yield immediate vertebral stabilization, relieve pain, and restore function with minimal associated morbidity.
骨质疏松性椎体压缩骨折（OVCFs）随着年龄增长越来越常见，并且与显著的发病率、死亡率及费用相关。我们评估了因OVCFs接受经皮椎体成形术（PVP）患者的临床疗效、影像学及功能结局，特别关注新的椎体压缩骨折（VCFs）的发生率。
本研究于2018年至2020年开展，纳入22名女性和4名男性。他们平均年龄60.15岁（范围50 - 70岁），平均随访14.5个月（范围12 - 36个月），在T7 - L2节段有30处VCFs。研究了多个变量，包括椎体前缘高度（AVH）和后凸角（KA）、新的VCFs以及功能结局。
PVP术后12个月时，视觉模拟评分和Oswestry功能障碍指数显著降低。AVH和KA的改善也具有统计学意义；23例患者（88.46%）术后第1天疼痛明显减轻，而3例患者（11.53%）在术后第1天至术后1个月PVP后疼痛未减轻。除6例患者8个节段（26.67%）出现高发生率的骨水泥渗漏外，未观察到重大并发症。此外，8例患者的10个椎体出现了新的VCFs（30.76%），其中6个为相邻椎体（60%），4个为非相邻椎体（40%）。
PVP是治疗药物治疗无效的疼痛性OVCFs的有效方法。这些PVP手术能立即实现椎体稳定，缓解疼痛，并以最小的相关发病率恢复功能。
