Zhong Chen, Min Gang, Liu Xun-Wei, Yang Zhen, Li Shuai, Li Min
Department of Oncology, PLA 960th Hospital, Jinan, Shandong, P.R. China.
Department of Radiology, Taian Disabled Solders' Hospital of Shandong Province, Taian, Shandong, P.R. China.
Pain Physician. 2021 Jul;24(4):E477-E482.
Reported data indicate that the curative effect of percutaneous vertebroplasty (PVP) on the patients with intravertebral vacuum cleft (IVC) is worse than on those without IVC.
This study was to prospectively investigate the advantage of rotary cutter-PVP (RC-PVP) in patients with Kümmell's disease with IVC.
A prospective outcome study.
A tertiary care hospital.
Patients who underwent conventional PVP served as the control group. For the RC-PVP group, the rotary cutters were applied before the cement injection to destroy the IVC structure and the surrounding necrotic bone. The following data were compared between the two groups: the cement filling patterns, effective therapeutic rate, the pre- to post-procedural changes of spinal geometry, and the subsequent fractures.
This study included a total of 64 patients (30 and 34 patients in RC-PVP group and control group, respectively). In the RC-PVP group, the cement in 26 cases was filled as a mixed pattern, while the filling pattern in the control group was mainly the cystic type (n = 31). There were no significant differences in the height restoration rate between the RC-PVP and control groups (32.7 ± 13.6 and 32.4 ± 13.9, respectively, P = 0.93). The RC-PVP group had a higher effective rate during the first week and the first month (93.3% vs. 70.6%, P = 0.02) and at 3 months (90.4% vs. 73.9%, P = 0.03). Long-term follow-up indicated that vertebral recollapse of the same treated vertebral body occurred in 5 patients after conventional PVP, which was not observed in the RC-PVP group.
The small number of included patients and no long-term follow-up.
RC-PVP, with the destruction of IVC, may lead to better clinical outcomes with fewer complications.
报告数据表明，经皮椎体成形术（PVP）对存在椎体内真空裂隙（IVC）的患者的疗效比对无IVC患者的疗效差。
本研究旨在前瞻性地探讨旋转切割器辅助PVP（RC-PVP）在患有IVC的Kümmell病患者中的优势。
一项前瞻性结局研究。
一家三级医疗中心。
接受传统PVP的患者作为对照组。对于RC-PVP组，在注入骨水泥前使用旋转切割器破坏IVC结构及周围坏死骨。比较两组以下数据：骨水泥填充模式、有效治疗率、脊柱形态术前至术后的变化以及后续骨折情况。
本研究共纳入64例患者（RC-PVP组30例，对照组34例）。RC-PVP组26例骨水泥呈混合模式填充，而对照组主要为囊状填充（n = 31）。RC-PVP组与对照组在椎体高度恢复率上无显著差异（分别为32.7±13.6和32.4±13.9，P = 0.93）。RC-PVP组在第1周和第1个月的有效率更高（93.3%对70.6%，P = 0.02），3个月时也更高（90.4%对73.9%，P = 0.03）。长期随访表明，传统PVP后5例患者出现同一治疗椎体的椎体再塌陷，RC-PVP组未观察到这种情况。
纳入患者数量少且无长期随访。
RC-PVP通过破坏IVC，可能带来更好的临床结局且并发症更少。
