Department of Neurosurgery, Başkent University School of Medicine, Ankara, Turkey.
Department of Neurosurgery, Başkent University School of Medicine, Ankara, Turkey.
World Neurosurg. 2023 Aug;176:e447-e455. doi: 10.1016/j.wneu.2023.05.081. Epub 2023 May 29.
The purpose of this study was to determine whether percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BK) have any mid-term to long-term effects on the structural integrity of augmented vertebrae.
According to our hospital records, 351 patients underwent BK and PVP as a result of osteoporotic vertebral compression fractures between 2010 and 2020. The demographic, surgical, and radiologic characteristics of the patients were analyzed retrospectively using the electronic hospital records and PACS (picture archiving and communication system). In our study, 55 patients who had a single level of PVP or BK filled with at least 6 mL og polymethylmethacrylate (PMMA) for T11-L5 levels and 3 mL of PMMA for T6-T10 levels via a bipedicular approach and who had only 1 vertebral fracture in a 10-year follow-up period were included in our study. The patients were divided into 2 groups: BK (n = 40) and PVP (n = 15). All measurements were performed on standing lateral radiographs from the postoperative first day and the last radiographs that were obtained during the follow-up. The anterior and posterior heights of the fractured vertebral body and local kyphosis angles were measured.
The mean follow-up time was 2.53 ± 1.78 years in the BK group and 3.07 ± 2.02 years in the PVP group. The decrease in the vertebral height and increasing kyphosis that develop from the early to late postoperative periods were found to be statistically significant in the BK group (P < 0.05). In the PVP group, vertebral height and kyphosis angle measurements did not differ significantly between the early and late postoperative periods. In addition, in terms of the percentage change, anterior parts of the vertebral bodies are more affected. However, the absolute difference for the measurement of the vertebral heights did not confirm this finding.
To our knowledge, our study is unique because it has the longest follow-up in the literature comparing BK and PVP in terms of recollapse of the augmented vertebrae. Our study shows that BK does not prevent height loss of the augmented vertebral bodies in the mid- to long term.
本研究旨在确定经皮椎体成形术（PVP）和球囊扩张椎体后凸成形术（BK）对增强椎体结构完整性是否具有中期至长期影响。
根据我院病历资料，2010 年至 2020 年，351 例骨质疏松性椎体压缩骨折患者行 BK 和 PVP 治疗。回顾性分析电子病历和 PACS（影像归档和通信系统）的患者人口统计学、手术和影像学特征。本研究纳入了 55 例患者，他们均通过双侧入路向 T11-L5 水平注入至少 6mL 的聚甲基丙烯酸甲酯（PMMA），向 T6-T10 水平注入 3mL 的 PMMA，用于治疗单一水平的 PVP 或 BK，且在 10 年随访期间仅发生 1 处椎体骨折。将患者分为 2 组：BK 组（n=40）和 PVP 组（n=15）。所有测量均在术后第 1 天和随访期间获得的最后 1 张站立侧位 X 线片上进行。测量骨折椎体的前、后高度和局部后凸角。
BK 组的平均随访时间为 2.53±1.78 年，PVP 组为 3.07±2.02 年。BK 组术后早期至晚期，椎体高度下降和后凸角增加均有统计学意义（P<0.05）。PVP 组术后早期和晚期椎体高度和后凸角测量值无显著差异。此外，就百分比变化而言，椎体前部受影响更大。然而，椎体高度测量的绝对差异并不能证实这一发现。
据我们所知，我们的研究是独特的，因为它是文献中比较 BK 和 PVP 治疗增强椎体再塌陷的随访时间最长的研究。我们的研究表明，BK 并不能防止增强椎体的中远期高度丢失。
