Lotan Raphael, Haimovich Yaron, Schorr Louis, Goldstein Adam Lee, Hershkovich Oded
Department of Orthopedic Surgery, Wolfson Medical Center, Affiliated to the Faculty of Medicine, Tel Aviv University, Ha-Lokhamim St. 62, Holon 5822012, Israel.
Trauma Unit, Wolfson Medical Center, Affiliated to the Faculty of Medicine, Tel Aviv University, Holon 5822012, Israel.
J Clin Med. 2022 Jun 14;11(12):3407. doi: 10.3390/jcm11123407.
Studies have found that unilateral and bilateral kyphoplasty have comparable clinical outcomes. Only a few studies have compared the radiographic results of using unilateral vs. simultaneous bilateral approaches. We aimed to examine and compare the radiographic results of unilateral (UKP) vs. bilateral simultaneous double-balloon kyphoplasty (DKP) for treating symptomatic vertebral compression fractures (VCF).
A retrospective cohort of all patients treated for VCF by DKP and UKP over five years in a single medical center. From 2009 to 2012, we routinely performed UKP; from 2012, DKP was the routine due to potential benefits in vertebral realignment. We evaluated pre- and post-surgical fracture characteristics including vertebral height, sagittal and coronal Cobb angle, and fracture reduction. Statistical analysis included a -test for independent variables and Pearson's correlation.
The study cohort consisted of 81 patients (75.8 years ± 10.86) who underwent surgery, with a total of 119 vertebras. We performed 89 UKP on fractured vertebras and 30 DKP on 30 vertebrae. The UKP average fluoroscopy radiation exposure was 15.8 mGy (±11.5) per level compared to 11.2 mGy (±8.7) for DKP, = 0.03. DKP showed significant fracture reduction, 2.8 degrees of Cobb angle, equaling the patient positioning effect on fracture reduction.
DKP results in better fracture reduction than UKP, and equals the effect of patient positioning without increased radiation exposure or adverse events.
研究发现，单侧和双侧椎体后凸成形术具有相当的临床疗效。仅有少数研究比较了单侧与同步双侧入路的影像学结果。我们旨在研究和比较单侧（UKP）与双侧同步双球囊椎体后凸成形术（DKP）治疗症状性椎体压缩骨折（VCF）的影像学结果。
对在单一医疗中心接受DKP和UKP治疗VCF的所有患者进行一项回顾性队列研究。2009年至2012年，我们常规进行UKP；自2012年起，由于在椎体复位方面可能存在的益处，DKP成为常规术式。我们评估了手术前后的骨折特征，包括椎体高度、矢状面和冠状面Cobb角以及骨折复位情况。统计分析包括对自变量的t检验和Pearson相关性分析。
研究队列包括81例接受手术的患者（75.8岁±10.86），共119个椎体。我们对89个骨折椎体进行了UKP，对30个椎体进行了30次DKP。UKP平均每节段透视辐射暴露量为15.8 mGy（±11.5），而DKP为11.2 mGy（±8.7），P = 0.03。DKP显示出显著的骨折复位，Cobb角减少2.8度，等同于患者体位对骨折复位的影响。
与UKP相比，DKP能实现更好的骨折复位，且等同于患者体位的效果，同时不会增加辐射暴露或不良事件。
