Department of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, 810-8563, Japan.
Department of Clinical Research, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka City, Fukuoka Province, 810-8563, Japan.
Jpn J Radiol. 2023 Jan;41(1):1-13. doi: 10.1007/s11604-022-01322-w. Epub 2022 Aug 9.
A narrative review regarding percutaneous vertebroplasty (PVP) for osteoporotic vertebral fracture (OVF) is provided herein, addressing the epidemic of OVF in Japan, the latest response to the criticism of PVP for OVFs, the indications and potential risks of PVP for OVFs, and a future perspective for PVP. Each year in Japan, approximately 32,000 patients aged 55 years or older suffer from chronic low back pain for several months to several years due to a compression fracture. PVP is one of the surgical treatments for an OVF, and it is less invasive compared to the traditional open surgery. PVP is suitable for OVF patients who have difficulty walking as assessed by the modified Yokoyama's activities of daily living (ADL) scoring system, and for patients with Kummell's disease diagnosed by CT and MRI examinations. Serious adverse events related to PVP occur in 1.1-3.3% of the cases, but direct deaths from PVP are extremely rare at less than 1%. Recent studies demonstrated that OVF patients treated with PVP are less likely to die after the treatment than non-surgically treated patients, which conflicts with the Cochran reviews' conclusion not supporting PVP for OVFs. Novel robotic systems and procedure-support devices are being developed, providing a next step toward fully automated PVP procedures.
本文提供了一篇关于经皮椎体成形术（PVP）治疗骨质疏松性椎体骨折（OVF）的叙述性综述，内容涉及日本 OVF 的流行情况、对 PVP 治疗 OVF 的批评的最新回应、PVP 治疗 OVF 的适应证和潜在风险，以及 PVP 的未来展望。在日本，每年约有 32000 名 55 岁或以上的患者因压缩性骨折而遭受数月至数年的慢性腰痛。PVP 是 OVF 的一种手术治疗方法，与传统的开放性手术相比，它的创伤较小。PVP 适用于改良 Yokoyama 日常生活活动（ADL）评分系统评估为行走困难的 OVF 患者，以及 CT 和 MRI 检查诊断为 Kummell 病的患者。与 PVP 相关的严重不良事件发生率为 1.1%-3.3%，但直接死于 PVP 的情况极为罕见，不到 1%。最近的研究表明，接受 PVP 治疗的 OVF 患者在治疗后死亡的可能性低于未接受手术治疗的患者，这与 Cochrane 综述的结论相矛盾，该结论不支持 PVP 治疗 OVF。新型机器人系统和程序支持设备正在开发中，为全自动 PVP 程序提供了下一步发展方向。
