椎体成形术治疗脆性骨折和肿瘤骨折:风险和益处

Q4 Medicine Coluna/ Columna Pub Date : 2022-01-01 DOI:10.1590/s1808-185120222104261926
Rafael Barreto Silva, José Carlos Barbe Gonçalves, Rafael Belloni Cabral, Luiz Henrique Mendes dos Santos, E. A. Galdeano, Carlos Andres Amelunge Rodriguez, Gabriela Aiello Fernandes Pantarotto
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引用次数: 1

摘要

目的:评价经皮椎体成形术(PV)治疗脊柱脆性骨折(骨质疏松/肿瘤)的效果,分析可能的并发症。方法:我们评估了33例因骨质疏松或肿瘤而脊柱骨折(FXV)的患者,这些患者在2021年1月至11月期间接受了PV手术。进行体格检查,获得骨脆性/肿瘤的病史和危险因素,并对脊柱进行放射学评估以证实FXV。采用Genant的半定量方法进行术后分类、VAS评分和残疾问卷(ODI)。放射科医生评估了断层扫描控制,以量化椎体填充和外渗,确定它们发生的位置。结果:33例患者共进行了46节椎骨手术,平均年龄71岁,11例患者进行了一级以上手术。其中肿瘤骨折13例,不全骨折20例。PMMA外渗31个椎体,多见于椎外静脉丛(23个)、椎间盘体(9个)、硬膜前隐窝(4个)、肺血管(4个)、椎内静脉丛(3个)、下腔静脉(2个)、脂肪平面(2个)和奇静脉(1个)。无临床并发症发生。术前平均VAS为8,术后平均VAS为3,术前平均ODI为56,术后平均ODI为30。结论:PMMA外渗多部位、多水平,无临床并发症。VP被证明在改善疼痛和功能方面是有效的。第三级;纵向回顾性队列研究。
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VERTEBROPLASTY IN BONE FRAGILITY FRACTURES AND TUMOR FRACTURES: RISKS AND BENEFITS
ABSTRACT Objective: To evaluate the results of percutaneous vertebroplasty (PV) in spinal fragility fractures (osteoporosis/tumor), analyzing possible complications. Method: We evaluated 33 patients with spinal fractures (FXV) due to osteoporosis or tumor who underwent PV between January and November 2021. A physical examination was performed, obtaining the history and risk factors for bone fragility/tumor and a radiological evaluation of the spine to verify FXV. Genant’s semiquantitative method was used for postoperative classification, the VAS score, and a disability questionnaire (ODI). A radiologist evaluated tomographic control to quantify vertebral filling and extravasation, determining where they occurred. Results: 46 vertebrae of 33 patients were operated on, with a mean age of 71 years, and 11 patients with more than one level of surgery. Of the total, 13 patients had tumor fractures, and 20 had fractures due to insufficiency. PMMA extravasation was observed in 31 vertebrae, most frequently in the External Vertebral Venous Plexus (23), Discal Body (9), Anterior Epidural Recess (4), Pulmonary Vessels (4), Internal Vertebral Venous Plexus (3), Inferior Cava (2), Adipose Plane (2) and Azygos Vein (1). No patient had clinical complications. Furthermore, the mean preoperative VAS was eight, the postoperative one was 3, the mean preoperative ODI was 56, and the postoperative one was 30. Conclusion: PMMA extravasation was frequent in several locations and levels without any clinical complications. VP proved to be effective in improving pain and function. Level III; Longitudinal Retrospective Cohort Study.
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来源期刊
Coluna/ Columna
Coluna/ Columna Medicine-Surgery
CiteScore
0.40
自引率
0.00%
发文量
32
审稿时长
10 weeks
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