PDF(Pubmed)
Abstract：
Symptomatic osteoporotic compression fractures are commonly addressed through vertebroplasty and kyphoplasty. However, cement leakage poses a significant risk of neurological damage. We introduced \"aspiration percutaneous kyphoplasty\", also known as \"decompressed kyphoplasty\", as a method to mitigate cement leakage and conducted a comparative analysis with high viscosity cement vertebroplasty. We conducted a retrospective study that included 136 patients with single-level osteoporotic compression fractures. Among them, 70 patients underwent high viscosity cement vertebroplasty, while 66 patients received decompressed percutaneous kyphoplasty with low-viscosity cement. Comparison parameters included cement leakage rates, kyphotic angle alterations, and the occurrence of adjacent segment fractures. The overall cement leakage rate favored the decompressed kyphoplasty group (9.1% vs. 18.6%), although statistical significance was not achieved (p = 0.111). Nonetheless, the risk of intradiscal leakage significantly reduced in the decompressed kyphoplasty cohort (p = 0.011), which was particularly evident in cases lacking the preoperative cleft sign on X-rays. Kyphotic angle changes and the risk of adjacent segment collapse exhibited similar outcomes (p = 0.739 and 0.522, respectively). We concluded that decompressed kyphoplasty demonstrates efficacy in reducing intradiscal cement leakage, particularly benefiting patients without the preoperative cleft sign on X-rays by preventing intradiscal leakage.
摘要：
症状性骨质疏松性压缩性骨折通常通过椎体成形术和椎体后凸成形术解决。然而,水泥渗漏会带来严重的神经损伤风险。我们介绍了“抽吸式经皮椎体后凸成形术”，也被称为“减压椎体后凸成形术”，作为减轻骨水泥渗漏的方法，并与高粘度骨水泥椎体成形术进行了比较分析。我们进行了一项回顾性研究，包括136例单级别骨质疏松性压缩骨折患者。其中,70例患者接受高粘度骨水泥椎体成形术，66例患者接受了低粘度骨水泥减压经皮椎体后凸成形术。比较参数包括水泥渗漏率，后倾角改变,以及相邻节段骨折的发生。整体骨水泥渗漏率有利于减压后凸成形术组(9.1%vs.18.6%），虽然没有达到统计学意义(p=0.111).尽管如此，在减压后凸成形术队列中，椎间盘内漏的风险显着降低（p=0.011），这在缺乏X线术前裂痕的病例中尤为明显。后倾角变化和相邻节段塌陷的风险表现出相似的结果（分别为p=0.739和0.522）。我们得出的结论是，减压后凸成形术显示出减少椎间盘内水泥渗漏的功效，通过防止椎间盘内漏，特别有利于在X线片上没有术前裂隙征的患者。
