Minimum 7 Years Follow-up of Percutaneous Vertebroplasty in Osteoporotic Compression Fracture
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Introduction: Percutaneous vertebroplasty is effective surgical method for treating osteoporotic compression fracture. But there is a few data for long term follow-up clinical and radiologic result, especially injected cement features. We assessed the radiographic features of patients who underwent percutaneous vertebroplasty (PVP) in osteoporotic compression fractures with a minimum of 7 years follow-up retrospectively. Methods: Between January 2000 and August 2007, 253 patients were treated with PVP for osteoporotic compression fracture at our department; 81 patients died during follow-up and 101 patients (177 vertebras) were available for follow-up for over 7 years. We analyzed the radiologic outcome focused on injected cement feature. Results: The mean follow-up period was 7.9 years. A new adjacent vertebral fracture was documented by 55 vertebral bodies in 35 patients. During the follow-up period, 81 patients (44.5%) in 182 patients died. Anterior body height in the last follow-up was improved about 0.3 mm compared with the preprocedural value , but was not statistically significant. Also, the focal kyphotic angle was reduced from 12.3° at the preprocedural state to 11.7° at the postprocedural state but was not statistically significant (P>0.05). Out of the 101 cases, the 89 cases for whom the cement was injected into the vertebral body were kept in a stable condition. Seven cases of radiolucent line with decreased bone density in the adjacent area of cement and 5 cases of cement cracks accompanied with vertebral collapse were observed. Conclusions: PVP for osteoporotic compression fracture is an efficient procedure for pain relief by long term follow-up. The cement injected vertebrae showed stable radiologic progression without significant changes in vertebral height or kyphotic angle.
Abstract
Introduction: Percutaneous vertebroplasty is effective surgical method for treating osteoporotic compression fracture. But there is a few data for long term follow-up clinical and radiologic result, especially injected cement features. We assessed the radiographic features of patients who underwent percutaneous vertebroplasty (PVP) in osteoporotic compression fractures with a minimum of 7 years follow-up retrospectively. Methods: Between January 2000 and August 2007, 253 patients were treated with PVP for osteoporotic compression fracture at our department; 81 patients died during follow-up and 101 patients (177 vertebras) were available for follow-up for over 7 years. We analyzed the radiologic outcome focused on injected cement feature. Results: The mean follow-up period was 7.9 years. A new adjacent vertebral fracture was documented by 55 vertebral bodies in 35 patients. During the follow-up period, 81 patients (44.5%) in 182 patients died. Anterior body height in the last follow-up was improved about 0.3 mm compared with the preprocedural value , but was not statistically significant. Also, the focal kyphotic angle was reduced from 12.3° at the preprocedural state to 11.7° at the postprocedural state but was not statistically significant (P>0.05). Out of the 101 cases, the 89 cases for whom the cement was injected into the vertebral body were kept in a stable condition. Seven cases of radiolucent line with decreased bone density in the adjacent area of cement and 5 cases of cement cracks accompanied with vertebral collapse were observed. Conclusions: PVP for osteoporotic compression fracture is an efficient procedure for pain relief by long term follow-up. The cement injected vertebrae showed stable radiologic progression without significant changes in vertebral height or kyphotic angle.
참고문헌 (17)
- 정호원, "흉요추 이행부 단순 압박 및 안정 방출성 골절의 보존적 치료 : 조기 보행군과 지연 보행군의 비교", 대한정형외과학회지, 37(4), pp.14~ (2002), 대한정형외과학회
- Suk SI, "Vertebral fracture in osteoporosis", J Korean Orthop Assoc, 28, pp.980~987 (1993)
- Weinstein JN, "Thoracolumbar “burst” fractures treated conservatively: a long-term follow-up", Spine (Phila Pa 1976), 13, pp.33~38 (1988)
- Jensen ME, "Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects", AJNR Am J Neuroradiol, 18, pp.1897~1904 (1997)
- Layton KF, "Vertebroplasty, first 1000 levels of a single center: evaluation of the outcomes and complications", AJNR Am J Neuroradiol, 28, pp.683~689 (2007)
- Barr JD, "Percutaneous vertebroplasty for pain relief and spinal stabiliza- tion", Spine (Phila Pa 1976), 25, pp.923~928 (2000)
- Grados F, "Long-term observations of vertebral osteoporotic fractures treated by percutaneous vertebroplasty", Rheumatology (Oxford), 39, pp.1410~1414 (2000)
- Pérez-Higueras A, "Percutaneous vertebroplasty: longterm clinical and radiological outcome", Neuroradiology, 44, pp.950~954 (2002)
- Lau E, "Mortality following the diagnosis of a vertebral compression fracture in the medicare population", J Bone Joint Surg Am, 90, pp.1479~1486 (2008)
- Rockwood CA, "Rockwood and Green’s fractures in adults. Vol. 3", pp.4~11 (2006), Lippincott Williams &Wilkins
- Uppin AA, "Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis", Radiology, 226, pp.119~124 (2003)
- Togawa D, "Histologic evaluation of human vertebral bodies after vertebral augmentation with polymethyl methacrylate", Spine (Phila Pa 1976), 28, pp.1521~1527 (2003)
- Braunstein V, "Long-term reaction to bone cement in osteoporotic bone: new bone formation in vertebral bodies after vertebroplasty", J Anat, 212, pp.697~701 (2008)
- Tsai TT, "Polymethylmethacrylate cement dislodgment following percutaneous vertebroplasty:a case report", Spine (Phila Pa 1976), 28, pp.E457~460 (2003)
- Cunin G, "Experimental vertebroplasty using osteo- conductive granular material", Spine (Phila Pa 1976), 25, pp.1070~1076 (2000)
- Bostrom MP, "Future directions: augmentation of osteoporotic vertebral bodies", Spine (Phila Pa 1976), 22(24 Suppl), pp.38S~42S (1997)
- Cotten A, "Vertebroplasty: current data and future potential", Rev Rhum Engl Ed, 64, pp.645~649 (1997)