Lotan Raphael, Lan Itzik, Sakhnini Mojahed, Klatzkin Lev, Hershkovich Oded
Department of Orthopedic Surgery, Wolfson Medical Center, Tel Aviv University School of Medicine, Tel Aviv, Israel.
Department of Orthopedic Surgery, Rivka Ziv Medical Center, Maimonides, Ziv Medical Centre, Bar-Ilan University's Azrieli Faculty of Medicine, Safed, Israel.
Global Spine J. 2025 Apr;15(3):1743-1748. doi: 10.1177/21925682241261343. Epub 2024 Jun 2.
Study DesignRetrospective cohort study.ObjectiveOsteoporotic vertebral compression fractures (VCFs) are prevalent among the elderly population, and Balloon kyphoplasty (BKP) is a minimally invasive solution for these. However, Polymethylmethacrylate (PMMA) leakage is a significant complication with potentially severe consequences. This study compares the safety and efficacy of manual balloon tamp system (MTS) and hydraulic Polymethylmethacrylate pressure delivery system (HPDS) in BKP.MethodsA retrospective study involving 160 patients, comparing MTS (2008-2014) and HPDS (2016-2020) cohorts, assessed PMMA leakage, radiation exposure, and surgery duration.ResultsPMMA leakage occurred in 52.8% of MTS and 62.5% of HPDS cases. Intradiscal leakage was the most common pattern in both groups. Multivariate logistic regression revealed that multilevel BKP and HPDS were associated with higher PMMA leakage rates. Radiation exposure was significantly lower with HPDS, while surgery duration was shorter.DiscussionThis study provides novel insights into PMMA leakage and radiation exposure in BKP. HPDS was associated with a higher PMMA leakage rate. HPDS, however, offers advantages in terms of reduced radiation exposure and shorter surgery duration. Multilevel BKP also increased the risk of leakage. Further investigation is needed to better understand the impact of HPDS on PMMA leakage.ConclusionThis study underscores that while HPDS offers advantages regarding radiation exposure and surgery duration, it is associated with a higher PMMA leakage rate.
研究设计
回顾性队列研究。
目的
骨质疏松性椎体压缩骨折（VCF）在老年人群中很常见，球囊椎体后凸成形术（BKP）是针对这些骨折的一种微创解决方案。然而，聚甲基丙烯酸甲酯（PMMA）渗漏是一种严重并发症，可能会产生严重后果。本研究比较了手动球囊填塞系统（MTS）和液压聚甲基丙烯酸甲酯压力输送系统（HPDS）在BKP中的安全性和有效性。
方法
一项回顾性研究，涉及160例患者，比较MTS组（2008 - 2014年）和HPDS组（2016 - 2020年），评估PMMA渗漏、辐射暴露和手术时长。
结果
MTS组中52.8%的病例发生了PMMA渗漏，HPDS组为62.5%。椎间盘内渗漏在两组中都是最常见的类型。多因素逻辑回归显示，多节段BKP和HPDS与更高的PMMA渗漏率相关。HPDS的辐射暴露显著更低，而手术时长更短。
讨论
本研究为BKP中PMMA渗漏和辐射暴露提供了新的见解。HPDS与更高的PMMA渗漏率相关。然而，HPDS在减少辐射暴露和缩短手术时长方面具有优势。多节段BKP也增加了渗漏风险。需要进一步研究以更好地了解HPDS对PMMA渗漏的影响。
结论
本研究强调，虽然HPDS在辐射暴露和手术时长方面具有优势，但它与更高的PMMA渗漏率相关。
