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何时进行椎体成形术?单中心回顾性分析及文献复习。

When to perform vertebroplasty? A retrospective analysis from a single center and a review of the literature.

机构信息

Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.

Neuroradiology and Interventional Radiology, San Salvatore Hospital, L'Aquila, Italy.

出版信息

Acta Biomed. 2021 Sep 10;92(S5):e2021402. doi: 10.23750/abm.v92iS5.11955.

Abstract

BACKGROUND AND AIM

To establish an optimal timing for vertebroplasty in order to obtain a clinically important pain reduction and improving quality of live in patients with osteoporotic or traumatic vertebral fractures.

METHODS

This study includes 22 vertebroplasty procedures performed from October 2018 to July 2020 in 21 patients with traumatic or osteoporotic vertebral fractures (19 female, two men; age between 53 and 89 years). All treatments were executed under fluoroscopic guidance using 11 or 13 G needle through transpedicular or costovertebral unilateral approach. Each patient underwent conscious sedation, continuously monitored by an anesthesiologist. Preoperative MRI images, obtained by 3T or 1.5T MRI scanner, always showed bone marrow edema. The VAS scale and Roland Morris disability questionnaire (RMdq) were administered to patients before and after the treatment to evaluate pain and life quality.

RESULTS

7 patients were treated in the first month after the injury, one was treated twice; 8 patients in the second month, 6 in the third. We observed a reduction of: 5.5 points in the vas scale, 10.3 in the RMdq in the first month; 5.6 points vas, 11.6 points RMdq in the second month; 4 points vas and 9.75 points RMdq in the third month.

CONCLUSIONS

This study demostrated that, in our preliminary experience, vertebroplasty has the best outcome if performed at 2 months from injury.

摘要

背景与目的

为了获得临床上重要的疼痛缓解和提高生活质量,确定骨质疏松或创伤性椎体骨折患者行椎体成形术的最佳时机。

方法

本研究纳入了 2018 年 10 月至 2020 年 7 月期间 21 例创伤性或骨质疏松性椎体骨折患者(19 名女性,2 名男性;年龄 53-89 岁)的 22 例椎体成形术。所有治疗均在透视引导下通过经皮或肋椎关节单侧入路,使用 11 或 13G 针进行。每位患者均在麻醉师的连续监测下接受清醒镇静。术前 MRI 图像由 3T 或 1.5T MRI 扫描仪获得,均显示骨髓水肿。在治疗前后,使用视觉模拟评分(VAS)量表和 Roland Morris 残疾问卷(RMdq)对患者进行疼痛和生活质量评估。

结果

7 例患者在受伤后 1 个月内接受治疗,1 例接受了 2 次治疗;8 例在第 2 个月,6 例在第 3 个月。我们观察到以下变化:第 1 个月 VAS 评分降低 5.5 分,RMdq 评分降低 10.3 分;第 2 个月 VAS 评分降低 5.6 分,RMdq 评分降低 11.6 分;第 3 个月 VAS 评分降低 4 分,RMdq 评分降低 9.75 分。

结论

本研究初步表明,在我们的经验中,如果在受伤后 2 个月进行椎体成形术,效果最佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fd6/8477064/9d6f4cbbd306/ACTA-92-402-g001.jpg

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