척추성형술의 효과에 대한 논란
Debates of the Effectiveness of Vertebroplasty
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Vertebroplasty has become a common treatment for painful osteoporotic vertebral fractures, but there is limited evidence to support its use. We are debating what the effectiveness of vertebroplasty. Especially, published paper by Buchbinder using multicenter, randomized, double-blind, placebo-controlled trial methods, there were no beneficial effect of vertebroplasty as compared with a sham procedure in patients with painful osteoporotic vertebral fractures, at 1 week or at 1, 3, or 6 months after treatment. We have some problems about the risk of subsequent vertebral fractures, particularly in vertebrae that are adjacent to treated levels, sometimes after cement has leaked into the adjacent disk. But according to the previous many study and my experiences, Percutaneous vertebroplasty should be considered as a valid therapeutic option in symptomatic acute amyelic osteoporotic vertebral fractures with refractory pain after a short period of analgesic drug therapy. Therefore, I reviewed Buchbinder’s result and previous similar papers.
Abstract
Vertebroplasty has become a common treatment for painful osteoporotic vertebral fractures, but there is limited evidence to support its use. We are debating what the effectiveness of vertebroplasty. Especially, published paper by Buchbinder using multicenter, randomized, double-blind, placebo-controlled trial methods, there were no beneficial effect of vertebroplasty as compared with a sham procedure in patients with painful osteoporotic vertebral fractures, at 1 week or at 1, 3, or 6 months after treatment. We have some problems about the risk of subsequent vertebral fractures, particularly in vertebrae that are adjacent to treated levels, sometimes after cement has leaked into the adjacent disk. But according to the previous many study and my experiences, Percutaneous vertebroplasty should be considered as a valid therapeutic option in symptomatic acute amyelic osteoporotic vertebral fractures with refractory pain after a short period of analgesic drug therapy. Therefore, I reviewed Buchbinder’s result and previous similar papers.
참고문헌 (10)
- Johnell O, "An estimate of the worldwide prevalence and disability associated with osteoporotic fractures", Osteoporos Int, 17, pp.1726~1733 (2006)
- Diamond TH, "Management of acute osteoporotic vertebral fractures: a nonrandomized trial comparing percutaneous vertebroplasty with conservative therapy", Am J Med, 114, pp.257~265 (2003)
- Ploeg WT, "Percutaneous vertebroplasty asa treatment for osteoporotic vertebral compression fractures: a systematic review", Eur Spine J, 15, pp.1749~1758 (2006)
- Wardlaw D, "Efficacy and safety of balloon kyphoplasty compared with nonsurgical care for vertebral compression fracture (FREE): a randomised controlled trial", Lancet, 373, pp.1016~1024 (2009)
- "BMC Musculoskelet Disord", 2008, 156~
- Buchbinder R, "Vertebroplasty: a promising but as yet unproven intervention for painful osteoporotic spinal fractures", Med J Aust, 185, pp.351~352 (2006)
- Hulme PA, "Vertebroplasty and kyphoplasty: a systematic review of 69 clinical studies", Spine, 31, pp.1983~2001 (2006)
- Watts NB., "Is percutaneous vertebral augmentation (vertebroplasty) effective treatment for painful vertebral fractures?", Am J Med, 114, pp.326~328 (2003)
- Legroux-Gerot I, "Long-term follow-up of vertebral osteoporotic fractures treated by percutaneous vertebroplasty", Clin Rheumatol, 23, pp.310~317 (2004)
- Klazen CA, "Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compressin fractures (Vertos II) : an opnelabel randomized trial", Lancet, 376, pp.1085~1092 (2010)