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Vol. 48. Núm. 3.
Páginas 186-194 (Enero 2004)
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Vol. 48. Núm. 3.
Páginas 186-194 (Enero 2004)
DOI: 10.1016/S1888-4415(04)76195-0
Acceso a texto completo
Vertebroplastia percutánea para el tratamiento de las fracturas vertebrales por compresión de origen osteoporótico
Percutaneous vertebroplasty for the treatment of vertebral compression fractures osteoporotic
Visitas
...
M.K. Bhatnagara,*, S.K. Mathura, E. Cruz-Oliverb, E. Cáceresc
a Orthopaedic Unit Johns Hopkins University Hospital. Baltimore, Maryland, Estados Unidos
b Servicio de COT. Fundació Asil. Hospital General de Granollers
c Servicio de COT IMAS. Hospitales del Mar y la Esperanza. Barcelona
Información del artículo
Diseño del estudio

Estudio retrospectivo de la inyección percutánea de cemento de polimetilmetacrilato en el cuerpo vertebral (vertebroplastia percutánea) para el tratamiento de las fracturas vertebrales por compresión de origen osteoporótico.

Objetivos

Evaluar la eficacia de la vertebroplastia percutánea utilizando un abordaje extrapedicular y comparar los resultados con otros estudios.

Material y métodos

Estudio retrospectivo de 200 pacientes consecutivos (162 mujeres y 38 varones) a los que se practicó una vertebroplastia percutánea a múltiples niveles. Se inyectaron 909 vértebras (4,5 niveles por paciente) para tratar 616 fracturas vertebrales por compresión (3,1 fracturas por paciente). En todos los niveles se usó un abordaje extrapedicular, salvo en L5, donde se optó por un abordaje transpedicular. Se evaluaron el dolor y las complicaciones con un seguimiento medio de 30 meses.

Resultados

El 95% de los pacientes manifestaron una mejoría significativa del dolor. El tiempo medio de inyección fue de 10,2 minutos por vértebra, y el tiempo quirúrgico medio por paciente fue de 49 minutos. Las complicaciones fueron infrecuentes (2%), pero importantes. Hubo dos fallecimientos. Un paciente requirió descompresión quirúrgica por una radiculopatía L5 por extrusión de cemento, y otro precisó una toracotomía por un hemotórax.

Conclusiones

La vertebroplastia percutánea mediante abordaje extrapedicular se ha mostrado efectiva para disminuir el dolor secundario a las fracturas osteoporóticas. La técnica proporciona estabilidad a la columna vertebral, reduciendo el dolor y mejorando la capacidad funcional.

Palabras clave:
vertebroplastia
fracturas por compresión
osteoporosis
extrapedicular
polimetilmetacrilato
Study design

Retrospective study of the percutaneous injection of polymethylmetacrylate cement in the vertebral body, or percutaneous vertebroplasty, for the treatment of vertebral compression fractures of osteoporotic origin.

Aims

To evaluate the efficacy of percutaneous vertebroplasty using an extrapedicular approach and compare results with those of other studies.

Materials and methods

Retrospective study of 200 consecutive patients (162 women and 38 men) in which multilevel percutaneous vertebroplasty was performed. Injections were made in 909 vertebrae (4.5 per patient) to treat vertebral compression fractures (3.1 fractures per patient). The approach was extrapedicular except in L5, where a transpedicular approach was used. Pain and complications were evaluated with a mean follow-up of 30 months.

Results

Ninety-five percent of patients experienced significant pain relief. The mean injection time was 10.2 minutes per vertebra and the mean operative time per patient was 49 minutes. Complications were infrequent (2%) but important. There were two deaths. One patient required surgical decompression of an L5 root compression by extruded cement and the other required thoracotomy for hemothorax.

Conclusions

Extrapedicular percutaneous vertebroplasty has been shown to be effective in relieving pain due to osteoporotic fracture. The technique stabilizes the spinal column, reducing pain and improving functional capacity.

Key words:
vertebroplasty
compression fractures
osteoporosis
extrapedicular
polymethylmetacrylate
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