Pittet Thaïs, Cook Stéphane, Khatchatourov Gregory, Theumann Nicolas
Cardiology Department, University Fribourg, Fribourg, Switzerland.
Hirslanden Clinics Lausanne, Lausanne, Switzerland.
Front Cardiovasc Med. 2022 Feb 7;9:822540. doi: 10.3389/fcvm.2022.822540. eCollection 2022.
Although rare, sternal pseudarthrosis is encountered after cardiac surgery and impacts the quality of life by triggering motion-dependent chest pain. We thought to describe its treatment by percutaneous cementoplasty and report the clinical follow-up of patients treated in our institution.
This case series is a retrospective study based on five patients who benefited from a sternal cementoplasty as a treatment for symptomatic pseudarthrosis after cardiac surgery. The progression of the symptoms was assessed during clinical follow-up using the Quebec back pain disability (QBPD) scale and Visual Analog Scale (VAS).
None of the patients presented evidence of local complications or neurological disorders. The intra- et post-operative images show no major leak of the cement, no embolism and no damage to the internal mammary artery or the heart. All patients described an improved quality of life due to reduced pain in all-day clinical activities. The QBPD scores improved from 54.8 ± 29.3 to 30.0 ± 17.4 ( = 0.02) and the VAS from 7.0 ± 2.8 to 1.6 ± 1.6 ( = 0.01). Furthermore, three out of five patients could completely stop taking analgesics.
Sternal pseudarthrosis is a debilitating affliction that may complicate sternotomy after cardiac surgery. This series demonstrates that a more conservative approach such as cementoplasty can be successful in terms of reducing pain, and constitutes a promising technique in selected cases.
尽管罕见，但心脏手术后会出现胸骨假关节，它会引发与运动相关的胸痛，影响生活质量。我们旨在描述经皮骨水泥成形术对其的治疗方法，并报告在我们机构接受治疗的患者的临床随访情况。
本病例系列是一项回顾性研究，基于五例接受胸骨骨水泥成形术治疗心脏手术后有症状的假关节的患者。在临床随访期间，使用魁北克背痛残疾（QBPD）量表和视觉模拟量表（VAS）评估症状进展。
所有患者均未出现局部并发症或神经功能障碍的证据。术中及术后影像显示骨水泥无大量渗漏、无栓塞，且未损伤胸廓内动脉或心脏。所有患者均表示，由于全天临床活动中的疼痛减轻，生活质量得到改善。QBPD评分从54.8±29.3提高到30.0±17.4（P = 0.02），VAS评分从7.0±2.8提高到1.6±1.6（P = 0.01）。此外，五分之三的患者能够完全停止服用镇痛药。
胸骨假关节是一种使人衰弱的疾病，可能使心脏手术后的胸骨切开术复杂化。本系列研究表明，像骨水泥成形术这样更保守的方法在减轻疼痛方面可能是成功的，并且在特定病例中是一种有前景的技术。
