Benek Hüseyin Berk, Ulgen Tahsin, Tabanlı Alper, Ak Cafer, Akcay Emrah, Yilmaz Hakan
Department of Neurosurgery, University of Health Sciences Izmir Bozyaka Education and Research Hospital, Izmir, Türkiye.
Acta Orthop Traumatol Turc. 2025 Mar 17;59(1):63-68. doi: 10.5152/j.aott.2025.24064.
OBJECTIVE: To compare the clinical and radiological e!cacy of bone cement volumes injected during unilateral percutaneous balloon kyphoplasty for thoracolumbar vertebral compression fractures. METHODS: In this retrospective study, we reviewed data from 96 patients who underwent single-level unilateral kyphoplasty. The patients were categorized into 2 groups based on the cement volume injected: group 1 (cement volume "4 mL, minimum 3 mL; n=48) and group 2 (cement volume >4 mL, maximum 6 mL; n=48). The clinical outcomes, as assessed using the Oswestry Disability Index (ODI) and visual analog scale (VAS) scores, were evaluated preoperatively and then at the final follow-up 1 month postoperatively. The vertebral corpus height at the fracture level was measured at the anterior, middle, and posterior regions through sagittal computed tomography scanning. RESULTS: The mean age of the patients was 64.2 years in group 1 and 63.8 years in group 2. In group 1, the mean anterior vertebral height increased from 19.0 ± 3.3 mm preoperatively to 19.9 ± 3.2 mm postoperatively, whereas in group 2, it increased from 17.9 ± 3.8 mm to 19.6 ± 3.7 mm, respectively. The middle vertebral heights were 15.4 ± 2.5 mm preoperatively and 16.9 ± 2.8 mm postoperatively in group 1 and 16.0 ± 3.6 mm and 17.5 ± 3.2 mm, respectively, in group 2. Both groups exhibited significant improvements in ODI and VAS scores, with no significant di#erence between the groups. A statistically significant increase was recorded within each group for the anterior, middle, and posterior vertebral heights. However, a significantly greater increase was noted in the anterior height in group 2 compared to that in group 1 (P < .05). CONCLUSION: Unilateral kyphoplasty is an e#ective procedure for managing painful vertebral compression fractures. The greatest loss of vertebral height occurred in the middle column, which also exhibited the greatest potential for restoration. Thus, a higher cement volume facilitated greater restoration of the anterior column height. LEVEL OF EVIDENCE: Level III, Therapeutic Study.
目的：比较单侧经皮球囊后凸成形术治疗胸腰椎椎体压缩骨折时注入骨水泥量的临床和影像学疗效。 方法：在这项回顾性研究中，我们回顾了96例行单节段单侧后凸成形术患者的数据。根据注入的骨水泥量将患者分为两组：第1组（骨水泥量≤4 mL，最少3 mL；n = 48）和第2组（骨水泥量>4 mL，最多6 mL；n = 48）。使用奥斯威斯功能障碍指数（ODI）和视觉模拟量表（VAS）评分评估临床结局，在术前以及术后1个月的最终随访时进行评估。通过矢状面计算机断层扫描测量骨折节段椎体的前、中、后区域的椎体高度。 结果：第1组患者的平均年龄为64.2岁，第2组为63.8岁。在第1组中，椎体前平均高度从术前的19.0±3.3 mm增加到术后的19.9±3.2 mm，而在第2组中，分别从17.9±3.8 mm增加到19.6±3.7 mm。第1组椎体中部高度术前为15.4±2.5 mm，术后为16.9±2.8 mm，第2组分别为16.0±3.6 mm和17.5±3.2 mm。两组的ODI和VAS评分均有显著改善，两组间无显著差异。每组的椎体前、中、后高度均有统计学意义的增加。然而，与第1组相比，第2组的椎体前高度增加显著更大（P <.05）。 结论：单侧后凸成形术是治疗疼痛性椎体压缩骨折的有效方法。椎体高度最大丢失发生在中柱，其恢复潜力也最大。因此，较高的骨水泥量有助于前柱高度的更大恢复。 证据级别：三级，治疗性研究。
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