Öz
Amaç: Vertebra kırıklarında uygulanan perkütan balon kifoplasti yöntemi, popüler minimal invaziv bir tekniktir. Vertebra kırıkları çoğunlukla torakolomber bölgede meydana gelse de tüm vertebral kolonda kompresyon fraktürü görülebilir. Orta torakal seviyeler minimal invaziv işlemlerde komplikasyon açısından riskli bölgelerdendir. Çalışmamızda orta torakal vertebra kırıklarında uygulanan perkütan balon kifoplasti yönteminin vertebra yüksekliğine, kifoz açısına etkisini ve komplikasyonu olan sement kaçaklarını incelemeyi amaçladık.
Gereç ve Yöntem: 2017-2020 yılları arasında tek ya da çoklu seviye orta torakal vertebra fraktürü nedeni ile kifoplasti uygulanan hastaların radyolojik görüntüleri, hasta dosyaları ve patoloji sonuçları retrospektif olarak incelendi.
Bulgular: Çalışmaya toplamda 19 hasta (9 erkek ve 10 kadın) ve 28 işlem yapılan vertebra dâhil edildi. Hastaların yaş ortalaması 58.42 ± 18.79 (23-86) yıl olarak hesaplandı. Operasyon süresi 40,18 ± 15,01 dk (17-99) idi. İşlem sırasında kullanılan sement miktarı 3,68 ± 1,13 mL (1,5-7) idi. Postoperatif sement kaçağı 12 (%42,9) seviyede görüldü. Anterior ve median vertebra yükseklikleri ile kifoz açısı operasyon öncesine göre anlamlı ölçüde iyileşme gösterdi (p<0.001). Hastanede kalış süresi 4,42 ± 0,69 saat (4-6) olarak hesaplandı.
Sonuç: Balon kifoplasti yöntemi orta torakal vertebra seviyelerinde sement kaçağı riski fazla olmasına rağmen, vertebra yüksekliğinin restorasyonu ve kifoz açısını azaltması yönünden güvenilir bir tedavi yöntemidir.
Anahtar Kelimeler
Kaynakça
- Lavelle WF, Khaleel MA, Cheney R, Demers E, Carl AL. Effect of kyphoplasty on survival after vertebral compression fractures. Spine J. 2008; 8 (5): 763-9.
- Kasper DM. Kyphoplasty. Semin Intervent Radiol. 2010; 27 (2): 172-84.
- Edidin AA, Ong KL, Lau E, Kurtz SM. Mortality risk for operated and nonoperated vertebral fracture patients in the medicare population. J Bone Miner Res. 2011; 26 (7): 1617-26.
- Hiwatashi A, Moritani T, Numaguchi Y, Westesson PL. Increase in vertebral body height after vertebroplasty. AJNR Am J Neuroradiol. 2003; 24 (2): 185-9.
- Teyssedou S, Saget M, Pries P. Kyphopasty and vertebroplasty. Orthop Traumatol Surg Res. 2014 ;100 (1 Suppl): S169-79.
- Garnier L, Tonetti J, Bodin A, Vouaillat H, Merloz P, Assaker R, et al. Kyphoplasty versus vertebroplasty in osteoporotic thoracolumbar spine fractures. Short-term retrospective review of a multicentre cohort of 127 consecutive patients. Orthop Traumatol Surg Res. 2012; 98 (6 Suppl): S112-9.
- Wardlaw D, Cummings SR, Van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet. 2009; 373 (9668): 1016-24.
- Leech JA, Dulberg C, Kellie S, Pattee L, Gay J. Relationship of lung function to severity of osteoporosis in women. Am Rev Respir Dis. 1990; 141 (1): 68-71.
- Kircelli A, Coven I. Percutaneous Balloon Kyphoplasty Vertebral Augmentation for Compression Fracture Due to Vertebral Metastasis: A 12-Month Retrospective Clinical Study in 72 Patients. Med Sci Monit. 2018; 24: 2142-8.
- Kim HS, Kim SW, Ju CI. Balloon Kyphoplasty through Extrapedicular Approach in the Treatment of Middle Thoracic Osteoporotic Compression Fracture : T5-T8 Level. J Korean Neurosurg Soc. 2007; 42 (5): 363-6.
- Huang Z, Wan S, Ning L, Han S. Is unilateral kyphoplasty as effective and safe as bilateral kyphoplasties for osteoporotic vertebral compression fractures? A meta-analysis. Clin Orthop Relat Res. 2014; 472 (9): 2833-42.
- Liebschner MA, Rosenberg WS, Keaveny TM. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty. Spine (Phila Pa 1976). 2001; 26 (14): 1547-54.
- Belkoff SM, Mathis JM, Jasper LE, Deramond H. The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior. Spine (Phila Pa 1976). 2001; 26 (14): 1537-41.
- Wang H, Sribastav SS, Ye F, Yang C, Wang J, Liu H, et al. Comparison of Percutaneous Vertebroplasty and Balloon Kyphoplasty for the Treatment of Single Level Vertebral Compression Fractures: A Meta-analysis of the Literature. Pain Physician. 2015; 18 (3): 209-22.
- Taylor RS, Fritzell P, Taylor RJ. Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J. 2007; 16 (8): 1085-100.
- Bouza C, Lopez-Cuadrado T, Almendro N, Amate JM. Safety of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures in Europe: a meta-analysis of randomized controlled trials. Eur Spine J. 2015; 24 (4): 715-23.
- Ge J, Cheng X, Li P, Yang H, Zou J. The Clinical Effect of Kyphoplasty Using the Extrapedicular Approach in the Treatment of Thoracic Osteoporotic Vertebral Compression Fracture. World Neurosurg. 2019; 131: e284-e9.
Öz
Aim: Balloon kyphoplasty is a popular minimally invasive technique for vertebral fractures. Although vertebral fractures occur mostly in the thoracolumbar region, compression fractures can be seen in the entire vertebral column. The mid-thoracic levels are difficult areas in terms of complications in minimally invasive procedures. Our study aimed to examine the effect of balloon kyphoplasty on vertebral height, kyphosis angle, and cement leaks as a complication in mid-thoracic vertebral fractures.
Materials and Methods: Radiological images, patient files, and pathology results of patients who underwent kyphoplasty due to a single or multiple mid-thoracic vertebral fractures between 2017 and 2020 were retrospectively analyzed.
Results: A total of 19 patients (9 males and 10 females) and 28 operated vertebrae were included in the study. The mean age of the patients was 58.42±18.79 (23-86) years, and the mean operation time was 40.18±15.01 minutes (17-99). The amount of cement used during the procedures was 3.68±1.13 mL (1.5-7), and postoperative cement leakage was observed in 12 levels (42.9%). Anterior and median vertebral heights and kyphosis angle improved significantly compared to preoperative values (p<0.001). The duration of hospital stay was found to be 4.42±0.69 hours (4-6).
Conclusion: The balloon kyphoplasty method is reliable in restoring the vertebra and reducing the angle of kyphosis, although there is a high risk of cement leakage at mid-thoracic vertebrae levels.
Anahtar Kelimeler
Kaynakça
- Lavelle WF, Khaleel MA, Cheney R, Demers E, Carl AL. Effect of kyphoplasty on survival after vertebral compression fractures. Spine J. 2008; 8 (5): 763-9.
- Kasper DM. Kyphoplasty. Semin Intervent Radiol. 2010; 27 (2): 172-84.
- Edidin AA, Ong KL, Lau E, Kurtz SM. Mortality risk for operated and nonoperated vertebral fracture patients in the medicare population. J Bone Miner Res. 2011; 26 (7): 1617-26.
- Hiwatashi A, Moritani T, Numaguchi Y, Westesson PL. Increase in vertebral body height after vertebroplasty. AJNR Am J Neuroradiol. 2003; 24 (2): 185-9.
- Teyssedou S, Saget M, Pries P. Kyphopasty and vertebroplasty. Orthop Traumatol Surg Res. 2014 ;100 (1 Suppl): S169-79.
- Garnier L, Tonetti J, Bodin A, Vouaillat H, Merloz P, Assaker R, et al. Kyphoplasty versus vertebroplasty in osteoporotic thoracolumbar spine fractures. Short-term retrospective review of a multicentre cohort of 127 consecutive patients. Orthop Traumatol Surg Res. 2012; 98 (6 Suppl): S112-9.
- Wardlaw D, Cummings SR, Van Meirhaeghe J, Bastian L, Tillman JB, Ranstam J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial. Lancet. 2009; 373 (9668): 1016-24.
- Leech JA, Dulberg C, Kellie S, Pattee L, Gay J. Relationship of lung function to severity of osteoporosis in women. Am Rev Respir Dis. 1990; 141 (1): 68-71.
- Kircelli A, Coven I. Percutaneous Balloon Kyphoplasty Vertebral Augmentation for Compression Fracture Due to Vertebral Metastasis: A 12-Month Retrospective Clinical Study in 72 Patients. Med Sci Monit. 2018; 24: 2142-8.
- Kim HS, Kim SW, Ju CI. Balloon Kyphoplasty through Extrapedicular Approach in the Treatment of Middle Thoracic Osteoporotic Compression Fracture : T5-T8 Level. J Korean Neurosurg Soc. 2007; 42 (5): 363-6.
- Huang Z, Wan S, Ning L, Han S. Is unilateral kyphoplasty as effective and safe as bilateral kyphoplasties for osteoporotic vertebral compression fractures? A meta-analysis. Clin Orthop Relat Res. 2014; 472 (9): 2833-42.
- Liebschner MA, Rosenberg WS, Keaveny TM. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty. Spine (Phila Pa 1976). 2001; 26 (14): 1547-54.
- Belkoff SM, Mathis JM, Jasper LE, Deramond H. The biomechanics of vertebroplasty. The effect of cement volume on mechanical behavior. Spine (Phila Pa 1976). 2001; 26 (14): 1537-41.
- Wang H, Sribastav SS, Ye F, Yang C, Wang J, Liu H, et al. Comparison of Percutaneous Vertebroplasty and Balloon Kyphoplasty for the Treatment of Single Level Vertebral Compression Fractures: A Meta-analysis of the Literature. Pain Physician. 2015; 18 (3): 209-22.
- Taylor RS, Fritzell P, Taylor RJ. Balloon kyphoplasty in the management of vertebral compression fractures: an updated systematic review and meta-analysis. Eur Spine J. 2007; 16 (8): 1085-100.
- Bouza C, Lopez-Cuadrado T, Almendro N, Amate JM. Safety of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures in Europe: a meta-analysis of randomized controlled trials. Eur Spine J. 2015; 24 (4): 715-23.
- Ge J, Cheng X, Li P, Yang H, Zou J. The Clinical Effect of Kyphoplasty Using the Extrapedicular Approach in the Treatment of Thoracic Osteoporotic Vertebral Compression Fracture. World Neurosurg. 2019; 131: e284-e9.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 12 Eylül 2022 |
| Gönderilme Tarihi | 8 Aralık 2021 |
| Yayımlandığı Sayı | Yıl 2022 |