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Journal of Korean Neurosurgical Society 2004;35(4): 365-371.
Effect of Percutaneous Vertebroplasty with Polymethylmethacrylate to Osteoporotic Spinal Compression Fractures and Bursting Fractures.
Cheong Ho Noh, Jin seok Yi, Hyung Jin Lee, Ji Ho Yang, Il Woo Lee, Moon Chan Kim
Department of Neurosurgery, College of Medicine, The Catholic University of Korea, Daejon St. Mary's Hospital, Daejeon, Korea. yijinseok@yahoo.co.kr
The purpose of this study is to determine the efficacy and safety of percutaneous vertebroplasty for patients with osteoporotic spinal bursting fracture.
The authors reviewed retrospectively 77 patients who underwent percutaneous vertebroplasty for osteoporotic spinal fracture from May 1, 2000 to March 31, 2003. They were divided into simple compression, mild bursting and severe bursting fracture groups. Cause of injury, height loss of fractured vertebra, operation time interval after fracture, injected amount of polymethylmethacrylate, cement leakage and clinical outcome were investigated. RESULTS: Out of 77 patients, 29 cases (38%) were bursting fractures consisted of 23 mild (mean neural canal involvement=11%) and 6 severe cases (42.8%). Out of the 30 bursting fracture levels, bone cement leakages occurred in 15 vertebral levels (50%), which were more common compared with compression fracture (25%). But the improvement of back pain of the bursting fracture patients (83%) was not different from that of compression fracture patients (87%). In compression fractures, cement leakages were more common when vertebroplasty was done at the time of less than 10 days after onset of symptoms compared with more than 10 days.
Bone cement leakages are more common in bursting fractures than compression fractures. Nonetheless, the complication is not significant and the same clinical improvement could be anticipated. For elderly patients especially those having difficulty in open surgery under general anesthesia due to their condition, percutaneous vertebroplasty may be considered as a therapeutic option.
Key Words: Percutaneous vertebroplasty; Bursting fracture; Bone cement leakage; Osteoporosis
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