Department of Orthopaedic Surgery & Traumatology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 3010, Bern, Switzerland.
Spine Medicine Bern, Hirslanden Salem-Spital, Bern, Switzerland.
Eur Spine J. 2023 Mar;32(3):934-949. doi: 10.1007/s00586-023-07537-3. Epub 2023 Jan 30.
The aim of this study was to assess safety and efficacy of vertebral body stenting (VBS) by analyzing (1) radiographic outcome, (2) clinical outcome, and (3) perioperative complications in patients with vertebral compression fractures treated with VBS at minimum 6-month follow-up.
In this retrospective cohort study, 78 patients (61 ± 14 [21-90] years; 67% female) who have received a vertebral body stent due to a traumatic, osteoporotic or metastatic thoracolumbar compression fracture at our hospital between 2012 and 2020 were included. Median follow-up was 0.9 years with a minimum follow-up of 6 months. Radiographic and clinical outcome was analyzed directly, 6 weeks, 12 weeks, 6 months postoperatively, and at last follow-up.
Anterior vertebral body height of all patients improved significantly by mean 6.2 ± 4.8 mm directly postoperatively (p < 0.0001) and remained at 4.3 ± 5.1 mm at last follow-up compared to preoperatively (p < 0.0001). The fracture kyphosis angle of all patients improved significantly by mean 5.8 ± 6.9 degrees directly postoperatively (p < 0.0001) and remained at mean 4.9 ± 6.9 degrees at last follow-up compared to preoperatively (p < 0.0001). The segmental kyphosis angle of all patients improved significantly by mean 7.1 ± 7.6 degrees directly postoperatively (p < 0.0001) and remained at mean 2.8 ± 7.8 degrees at last follow-up compared to preoperatively (p = 0.03). Back pain was ameliorated from a preoperative median Numeric Rating Scale value of 6.5 to 3.0 directly postoperatively and further bettered to 1.0 six months postoperatively (p = 0.0001). Revision surgery was required in one patient after 0.4 years.
Vertebral body stenting is a safe and effective treatment option for osteoporotic, traumatic and metastatic compression fractures.
本研究旨在通过分析（1）影像学结果、（2）临床结果和（3）接受椎体支架置入术治疗的椎体压缩性骨折患者的围手术期并发症，评估椎体支架置入术（VBS）的安全性和有效性。本研究对 78 例患者（61±14 岁，21-90 岁；67%为女性）的临床资料进行回顾性分析，这些患者因创伤性、骨质疏松性或转移性胸腰椎压缩性骨折于 2012 年至 2020 年在我院接受 VBS 治疗。中位随访时间为 0.9 年，随访时间至少 6 个月。直接、术后 6 周、12 周、6 个月和末次随访时对影像学和临床结果进行分析。
所有患者的椎体前缘高度均明显改善，术后即刻平均增加 6.2±4.8mm（p<0.0001），末次随访时与术前相比平均增加 4.3±5.1mm（p<0.0001）。所有患者的骨折后凸角均明显改善，术后即刻平均改善 5.8±6.9°（p<0.0001），末次随访时与术前相比平均改善 4.9±6.9°（p<0.0001）。所有患者的节段后凸角均明显改善，术后即刻平均改善 7.1±7.6°（p<0.0001），末次随访时与术前相比平均改善 2.8±7.8°（p=0.03）。术后即刻，患者的腰痛从术前中位数数字评定量表（NRS）评分 6.5 分改善至 3.0 分，术后 6 个月进一步改善至 1.0 分（p=0.0001）。1 例患者在 0.4 年后需要翻修手术。
椎体支架置入术是治疗骨质疏松性、创伤性和转移性压缩性骨折的一种安全有效的治疗方法。
