From the Cleveland Clinic Akron General Medical Center, Akron, OH (Hoffmann and Preston) and University of Pittsburgh Medical Center, Pittsburgh, PA (Whaley), William Beaumont Hospital, Royal Oak, MI (Khalil).
J Am Acad Orthop Surg. 2023 May 15;31(10):477-489. doi: 10.5435/JAAOS-D-22-00958. Epub 2023 Mar 23.
Vertebral augmentation has been a well-studied adjunct percutaneous procedure in spine surgery. Cement augmentation has been used in the treatment of compression fractures through kyphoplasties or vertebroplasties. Historically, data have shown no difference between treating compression fractures conservatively versus with percutaneous cement augmentation procedures. Recent literature has shown improvement in patient outcomes and increase in mobility with percutaneous cement augmentation procedures. Cement augmentation has been used in treating patients with spinal column fractures in higher energy trauma. Cement augmentation has shown to have a reduction in local kyphosis, improved pain, and significant height restoration of the anterior column in patients with burst fractures. Augmentation has been used in spinal deformity surgery, specifically to attempt to reduce the risk of proximal junctional kyphosis and to decrease the risk of screw pullout with cement augmented fenestrated screws in patients with osteoporosis. In pathologic compression fractures, cement augmentation is a safe, viable intervention to improve pain control in these patients. This review will go into the new advances of vertebral augmentation and indications for use in treatment today.
椎体强化术是脊柱外科中一项经过充分研究的辅助经皮手术。骨水泥强化已被用于治疗通过后凸成形术或椎体成形术治疗的压缩性骨折。从历史上看，数据显示保守治疗与经皮骨水泥强化手术治疗压缩性骨折之间没有区别。最近的文献表明，经皮骨水泥强化手术可改善患者预后并提高活动能力。骨水泥强化已被用于治疗高能量创伤中脊柱骨折的患者。骨水泥强化可减少局部后凸畸形，改善疼痛，并显著恢复爆裂性骨折患者前柱的高度。强化已被用于脊柱畸形手术中，特别是试图降低近端交界性后凸的风险，并降低骨质疏松症患者中带有骨水泥增强的开窗螺钉的螺钉拔出风险。在病理性压缩性骨折中，骨水泥强化是一种安全可行的干预措施，可改善这些患者的疼痛控制。本文将介绍椎体强化术的新进展及其在当今治疗中的适应证。
