Song Tengfei, Sun Fan, Liu Shu, Ye Tianwen
Department of Orthopedics, Changzheng Hospital, Naval Medical University, Shanghai, China.
Department of Orthopedics, The Fourth Affiliated Hospital of Nangjing Medical University, Nanjing, Jiangsu, China.
Front Neurol. 2023 Jul 28;14:1132919. doi: 10.3389/fneur.2023.1132919. eCollection 2023.
The study aimed to explore the safety and effectiveness of percutaneous lordoplasty (PLP) in the treatment of severe osteoporotic vertebral compression fracture (OVCF).
Included in this prospective study were patients with single-segment acute severe OVCF who were treated with PLP in our institution from July 2016 to October 2019. Patients' back pain and quality of life were assessed using the visual analog scale (VAS) and SF-36 scores. Lateral X-ray radiography of the spine was performed to measure the vertebral height, vertebral kyphotic angle, and segmental kyphotic angle, and to evaluate the outcome of fracture reduction and kyphotic correction. Intra-and postoperative complications were recorded.
Of the 51 included patients, 47 patients were followed up for 12 months. The VAS score decreased from preoperative 7.33 ± 1.92 to postoperative 1.76 ± 0.85 at the 12th month ( < 0.05), and the SF-36 score increased from preoperative 79.50 ± 9.22 to postoperative 136.94 ± 6.39 at the 12th month ( < 0.05). During the 1-year follow-up period, the anterior height of the vertebral body increased significantly from preoperative 10.49 ± 1.93 mm to 19.33 ± 1.86 mm ( < 0.05); the posterior height of the vertebral body increased insignificantly from preoperative 22.23 ± 2.36 mm to 23.05 ± 1.86 mm ( > 0.05); the vertebral kyphotic angle decreased significantly from preoperative 18.33° ± 11.49° to 8.73° ± 1.21° ( < 0.05); and the segmental kyphotic angle decreased significantly from preoperative 24.48° ± 4.64° to 11.70° ± 1.34° ( < 0.05). During the 1-year follow-up period, there was no significant difference in the radiologic parameters, VAS scores, and SF-36 scores, between the 1st day and the 12th month of post-operation ( > 0.05). No nerve damage occurred in any of the cases. Intraoperative cement leakage occurred in six cases, and the fracture of the adjacent vertebral body occurred in one case.
PLP can well reduce the risk of fracture and achieve good kyphotic correction and may prove to be a safe, cost-effective and minimally invasive alternative option for the treatment of severe OVCF with kyphotic deformity.
本研究旨在探讨经皮椎体后凸成形术（PLP）治疗重度骨质疏松性椎体压缩骨折（OVCF）的安全性和有效性。
纳入2016年7月至2019年10月在本机构接受PLP治疗的单节段急性重度OVCF患者进行前瞻性研究。采用视觉模拟量表（VAS）和SF-36评分评估患者的背痛及生活质量。行脊柱侧位X线摄影测量椎体高度、椎体后凸角和节段后凸角，评估骨折复位及后凸矫正效果。记录术中及术后并发症。
纳入的51例患者中，47例患者获得12个月随访。第12个月时，VAS评分从术前的7.33±1.92降至术后的1.76±0.85（P<0.05），SF-36评分从术前的79.50±9.22升至术后的136.94±6.39（P<0.05）。在1年随访期内，椎体前缘高度从术前的10.49±1.93mm显著增加至19.33±1.86mm（P<0.05）；椎体后缘高度从术前的22.23±2.36mm增至23.05±1.86mm，增加不显著（P>0.05）；椎体后凸角从术前的18.33°±11.49°显著降至8.73°±1.21°（P<0.05）；节段后凸角从术前的24.48°±4.64°显著降至11.70°±1.34°（P<0.05）。在1年随访期内，术后第1天与第12个月的影像学参数、VAS评分及SF-36评分比较，差异无统计学意义（P>0.05）。所有病例均未发生神经损伤。术中发生骨水泥渗漏6例，发生相邻椎体骨折1例。
PLP能有效降低骨折风险，实现良好的后凸矫正，可能是治疗伴有后凸畸形的重度OVCF的一种安全、经济有效且微创的替代选择。
