Balloon kyphoplasty combined with percutaneous pedicle screw (PPS) for the treatment of osteoporotic thoracolumbar fractures has minimum correction loss 2 years after surgery: compared to vertebroplasty using hydroxyapatite block combined with PPS.

Autor:	Kojima A; Funabashi Orthopaedic Hospital, Spine and Spinal Cord Center, Funabashi, Japan; Department of Orthopaedic Surgery, Saint Joseph's Hospital, Yokosuka, Japan., Tsujishima N; Funabashi Orthopaedic Hospital, Spine and Spinal Cord Center, Funabashi, Japan., Kamitani S; Funabashi Orthopaedic Hospital, Spine and Spinal Cord Center, Funabashi, Japan., Urayama M; Funabashi Orthopaedic Hospital, Spine and Spinal Cord Center, Funabashi, Japan., Hatakeyama K; Funabashi Orthopaedic Hospital, Spine and Spinal Cord Center, Funabashi, Japan., Sodeyama T; Funabashi Orthopaedic Hospital, Spine and Spinal Cord Center, Funabashi, Japan., Ohuchi J; Funabashi Orthopaedic Hospital, Spine and Spinal Cord Center, Funabashi, Japan., Arai K; Department of Orthopaedic Surgery, Saint Joseph's Hospital, Yokosuka, Japan., Akazawa T; Department of Orthopaedic Surgery, St. Marianna University, School of Medicine, Kawasaki, Japan., Niki H; Department of Orthopaedic Surgery, St. Marianna University, School of Medicine, Kawasaki, Japan., Aihara T; Department of Orthopaedic Surgery, Tokyo Medical University, Tokyo, Japan.
Jazyk:	angličtina
Zdroj:	Annals of palliative medicine [Ann Palliat Med] 2023 Mar; Vol. 12 (2), pp. 301-310.
DOI:	10.21037/apm-22-1024
Abstrakt:	Background: Balloon kyphoplasty (BKP) is a useful treatment performed in patients with painful osteoporotic vertebral body fracture (OVF). However, in cases with large intra-vertebral clefts and cases with posterior spinal tissue damage, adjacent vertebral body fractures (AVFs), and cement migration may occur early after BKP, which may be a factor for poor results. In such cases, percutaneous vertebroplasty (PVP) combined with percutaneous pedicle screw (PPS) is useful treatment. This study compared BKP combined with PPS (BKP + PPS) compared to PVP using hydroxyapatite (HA) block combined with PPS (HAVP + PPS) for thoracolumbar OVF (TLOVF). Methods: Twenty-eight patients who sustained painful TLOVFs without neurologic deficits underwent HAVP + PPS (group H, n=14) or BKP + PPS (group B, n=14). We evaluated time from injury to surgery, pre- and post-operative visual analogue scale (VAS) of low back pain, wedging angle of fractured vertebra, duration of operation, intraoperative blood loss, number of instrumented vertebra, and length of stay at hospital. Results: Group B had significantly less surgery time and less blood loss during surgery. VAS of low back pain improved equally in both groups, but at 1 year and 2 years postoperatively, wedging angle of fractured vertebra progressed significantly in group H compared with group B. Conclusions: PPS fixation combined with percutaneous vertebral cement augmentation with BKP for OVF was suggested to be minimally invasive in the elderly patients. In addition, there is no correction loss of the fractured vertebral body after BKP + PPS, which is considered to be a useful surgical procedure.
Databáze:	MEDLINE
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