골다공증성 척추 압박 골절에서 경피적 척추성형술의 효과
Efficacy of Percutaneous Vertebroplasty in Osteoporotic Vertebral Compressive Fractures
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초록
Osteoporosis is an age-related progressive skeletal disease characterised by low bone mass and microarchitectural deterioration, with a consequent increase in bone fragility and susceptibility to fracture. The prevalence of osteoporosis increases dramatically with age, for both men and women. The most frequent osteoporotic fracture is the vertebral compression fracture. Osteoporotic vertebral compression fracture is known to cause physical, functional and mental side effects and complica¬tions such as lowered quality of life and increased mortality rate. The lifetime risk of such fractures will increase as the median age of the population continues to rise. Most of the patients can be treated successfully with conservative therapy, but in some cases pain persists and may result to general weakness and aggravation of osteoporosis from long time bed rest. Operative intervention should be considered for these patients. But, Operative interventions such as fusion and application of instrumentation are less attractive in these elderly patients, due to increased risks of anaesthesia, poor quality of bone and invasiveness. To reduce the risks of operative intervention a new treatment, vertebroplasty was introduced and it became popular as a treatment for osteoporotic fractures. As a treatment procedure, vertebroplasty is widely used due to its non-invasiveness. Moreover, many studies reported improvements in clinical symptoms upon obtaining immediate postoperative pain relief and vertebral stability. But, the complications such as cement leakage, nerve damage, new compression fracture in adjacent level, pulmonary embolism, infections must be considered. The purpose of this study is to assess the efficacy, safety and complications of vertebroplasty as a treatment in painful osteoporotic vertebral compression fractures by means of review of the current literature.
Abstract
Osteoporosis is an age-related progressive skeletal disease characterised by low bone mass and microarchitectural deterioration, with a consequent increase in bone fragility and susceptibility to fracture. The prevalence of osteoporosis increases dramatically with age, for both men and women. The most frequent osteoporotic fracture is the vertebral compression fracture. Osteoporotic vertebral compression fracture is known to cause physical, functional and mental side effects and complica¬tions such as lowered quality of life and increased mortality rate. The lifetime risk of such fractures will increase as the median age of the population continues to rise. Most of the patients can be treated successfully with conservative therapy, but in some cases pain persists and may result to general weakness and aggravation of osteoporosis from long time bed rest. Operative intervention should be considered for these patients. But, Operative interventions such as fusion and application of instrumentation are less attractive in these elderly patients, due to increased risks of anaesthesia, poor quality of bone and invasiveness. To reduce the risks of operative intervention a new treatment, vertebroplasty was introduced and it became popular as a treatment for osteoporotic fractures. As a treatment procedure, vertebroplasty is widely used due to its non-invasiveness. Moreover, many studies reported improvements in clinical symptoms upon obtaining immediate postoperative pain relief and vertebral stability. But, the complications such as cement leakage, nerve damage, new compression fracture in adjacent level, pulmonary embolism, infections must be considered. The purpose of this study is to assess the efficacy, safety and complications of vertebroplasty as a treatment in painful osteoporotic vertebral compression fractures by means of review of the current literature.
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