TOLGA AKKAYA, Salim ERSÖZLÜ, Ahmet Fevzi ÖZGÜR, Oğuz KARAEMİNOĞULLARI, Can Rahm AKGÜN, N. Reha TANDOĞAN

Osteoporotik vertebra kompresyon kırıklarında kifoplasti sonrası erken dönem sonuçlar

Amaç: Osteoporotik vertebra kompresyon kırığı (VKK) nedeniyle erken dönemde yapılan kifoplasti sonrası hastaların ağrı durumu, aktivite düzeyleri ve radyografik olarak vertebra cisminin restorasyonu değerlendirildi. Çalışma planı: Çalışmaya lomber bölgede oluşan osteoporotik VKK nedeniyle erken dönemde kifoplasti uygulanan 16 hasta (4 erkek, 12 kadın; ort. yaş 63; dağılım 55-72) alındı. Kifoplasti uygulanan toplam seviye sayısı 21 idi ve seviye başına en az 3 ml (dağılım 3-6 ml) çimento enjekte edildi. Semptomların başlaması ile cerrahi işlem arasındaki süre ortalama altı gündü (dağılım 2-16 gün). İşlemin etkinliğini değerlendirmek için, tanı konduğunda, kifoplasti sonrası birinci günde ve bir ay sonra görsel analog skala (GAS: 0 hiç ağrı yok, 10 çok şiddetli ağrı) kullanıldı. Kifoplasti öncesi ve sonrasında vertebra gövdesinin ön, orta ve arka yükseklikleri direkt grafilerde ölçülerek vertebranın restorasyonu değerlendirildi. Ortalama takip süresi 11 ay (dağılım 4-30 ay) idi. Sonuçlar: Girişim öncesinde ortalama 8.8 (dağılım 7-10) olan GAS skoru girişim sonrası birinci günde 2.4 (dağılım 1-5), birinci ayda 1.6 (dağılım 0-3) bulundu (p

Anahtar Kelimeler:

Kemik çimentosu, Enjeksiyon, spinal, Lumbar omurga, Ameliyat sonrası komplikasyonlar, Tedavi sonucu, Omurga kırıkları, Osteoporoz, Ağrı ölçümü, Yaralanma şiddeti skoru, Cerrahi işlemler, minimal invaziv

Early results of kyphoplasty in osteoporotic vertebral compression fractures

Objectives: We evaluated early results of kyphoplasty for osteoporotic vertebral compression fractures with regard to the level of pain, activity levels of patients, and radiographic restoration of the vertebra bodies. Methods: Sixteen patients (4 males, 12 females; mean age 63 years; range 55 to 72 years) with osteoporotic vertebral compression fractures in the lumbar spine were treated with kyphoplasty. The procedure was performed at 21 levels, with a minimum of 3 ml (range 3 to 6 ml) of cement per level. The mean time from the onset of symptoms to the application was six days (range 2 to 16 days). The effectiveness of the procedure was evaluated by a visual analog scale (VAS: 0 no pain; 10 very severe pain) before kyphoplasty, and after the first day and one month of the procedure. In addition, restoration of the vertebra bodies was assessed on pre- and postoperative radiographs by measuring the anterior, middle, and posterior heights. The mean follow-up was 11 months (range 4 to 30 months). Results: The mean VAS scores were 8.8 (range 7 to 10), 2.4 (range 1 to 5), and 1.6 (range 0 to 3) before kyphoplasty, and after the first day and one month of the procedure, respectively (p<0.0001). All the patients returned to preinjury levels of activity within the first month. No collapse or refracture occurred in the treated vertebrae. Changes in the anterior, middle, and posterior heights of the vertebra bodies after the procedure were not significant. The only complication was the development of an additional fracture in the nearby segment in two patients, for which kyphoplasty was performed. Conclusion: With proper patient selection, kyphoplasty is an effective and reliable option for osteoporotic vertebral compression fractures, yielding 80% to 95% success rates.

Keywords:

Bone Cements, Injections, Spinal, Lumbar Vertebrae, Postoperative Complications, Treatment Outcome, Spinal Fractures, Osteoporosis, Pain Measurement, Injury Severity Score, Surgical Procedures, Minimally Invasive,

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