Prospective Assessment of Pain and Functional Status After Percutaneous Vertebral Body-Perforation Procedure for Treatment of Vertebral Compression Fractures
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概要
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Percutaneous vertebral body perforation is a new technique for treating painful vertebral compression fractures (VCFs). We prospectively evaluated this treatment in 45 consecutive patients with 63 VCFs treated at our hospital between September and December 2009. In all patients, long-term conservative treatment had failed to achieve pain relief, resulting in reduced changes in activities of daily living (ADL). We evaluated visual analogue scale (VAS) scores for pain before and after vertebral body perforation as well as in the chronic phase, changes in ADL, whether recipients would recommend this treatment, and complications. The mean VAS score improved from 6.9 ± 1.9 before surgery to 3.6 ± 2.9 immediately after surgery, and to 2.5 ± 2.1 at 3 months. ADL was improved in 27 patients, and walking became possible in 16 of 24 patients who had been unable to walk. Nearly two-thirds of patients would strongly recommend this treatment to others. The analgesic effect of vertebral body perforation was significantly lower in patients with than in those without vertebral pseudarthrosis before surgery. Only 1 patient suffered a new fracture during the 3-month period after surgery, but there were no perioperative complications. Vertebral body perforation for painful VCFs can achieve early improvement of ADL due to the analgesic effect in carefully selected patients and is a safe treatment with a low frequency of complications.
著者
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Kuroiwa Toshihiko
Department Of Neuropathology Graduate School Of Medicine Tokyo Medical And Dental University
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Yokoyama Kunio
Department Of Neurosurgery Osaka Medical College
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Hirano Masashi
Department Of Electrical And Computer Engineering Nagoya Institute Of Technology
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Kawanishi Masahiro
Department Of Internal Medicine Hiroshima Mitsubishi Hospital
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Ito Yutaka
Department Of Chemistry Tokyo Metropolitan University
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Yamada Makoto
Department Of Chemistry And Biomolecular Science Toho University
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Tanaka Hidekazu
Department Of Chemistry And Chemical Biology Gunma University
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KUROIWA Toshihiko
Departments of Neurosurgery and Surgical Pathology, Osaka Medical College
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HIRANO Masashi
Department of Neurosurgery, Takeda General Hospital
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