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Early clinical outcome and complications related to balloon kyphoplasty

机译：球囊后凸成形术的早期临床结果和并发症

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The treatment of painful osteoporotic vertebral compression fractures using transpedicular cement augmentation has grown significantly over the last two decades. The benefits of balloon kyphoplasty compared to conservative treatment remain controversial and are discussed in the literature. The complication rates of vertebroplasty and kyphoplasty are considered to be low. The focus of this study was the analysis of acute and clinically relevant complications related to this procedure. In our department, all patients treated between February 2002 and February 2011 with percutaneous cement augmentation (372 patients, 522 augmented vertebral bodies) were prospectively recorded. Demographic data, comorbidities, fracture types, intraoperative data and all complications were documented. The pre- and postoperative pain-level and neurological status (Frankel-Score) were evaluated. All patients underwent a standardized surgical procedure. Two hundred and ninety-seven patients were treated solely by balloon kyphoplasty; 216 females (72.7%) and 81 males (27.3%). Average patient age was 76.21 years (±10.71, range 35–98 years). Average American Society Anestesiologists score was 3.02. According to the Orthopedic Trauma Association classification, there were 69 A 1.1 fractures, 177 A 1.2 fractures, 178 A 3.1.1 fractures and 3 A 3.1.3 fractures. Complications were divided into preoperative, intraoperative and postoperative events. There were 4 preoperative complications: 3 patients experienced persistent pain after the procedure. In one case, the pedicles could not be visualized during the procedure and the surgery was terminated. One hundred and twenty-nine (40.06%) of the patients showed intraoperative cement leaking outside the vertebras, one severe hypotension and tachycardia as reaction to the inflation of the balloons, and there was one cardiac arrest during surgery. Postoperative subcutaneous hematomas were observed in 3 cases, 13 patients developed a urinary tract infection, and 2 patients died during hospitalization. Twenty-four patients (8.1%) returned because of new pain events and 23 patients reported a new painful fracture. Balloon kyphoplasty is a save and effective procedure to treat patients with painful vertebral compression fractures. Rapid patient mobilization after kyphoplasty, as well as a prompt reintegration into the social environment, are possible. Compared to other surgical procedures, especially in patients with an average age of 75 years, balloon kyphoplasty seems to offer some advantages. However, the procedure still has a potential for serious complications and should be performed by well trained personnel.Key words: balloon kyphoplasty, outcome, complications, vertebral compression fractures.
机译：在过去的二十年中，使用经椎弓根骨水泥增强术治疗疼痛性骨质疏松性椎体压缩性骨折的方法已显着增长。与保守治疗相比，球囊后凸成形术的益处仍存在争议，并在文献中进行了讨论。椎骨成形术和后凸成形术的并发症发生率较低。这项研究的重点是分析与此程序相关的急性和临床相关并发症。在我们的科室中，前瞻性记录了2002年2月至2011年2月之间经皮水泥骨增强术治疗的所有患者（372例患者，522例椎体增强）。记录人口统计学数据，合并症，骨折类型，术中数据和所有并发症。评估术前和术后的疼痛水平和神经系统状况（Frankel-Score）。所有患者均接受标准化手术程序。仅球囊后凸成形术治疗了279例患者。 216位女性（72.7％）和81位​​男性（27.3％）。患者平均年龄为76.21岁（±10.71，范围35-98岁）。美国社会麻醉师平均评分为3.02。根据创伤骨科协会的分类，有69 A 1.1骨折，177 A 1.2骨折，178 A 3.1.1骨折和3 A 3.1.3骨折。并发症分为术前，术中和术后事件。有4例术前并发症：3例患者术后均出现持续性疼痛。在一种情况下，在手术过程中无法看到椎弓根，因此终止了手术。一百二十九（40.06％）的患者显示术中骨水泥渗漏到椎骨外，其中一种严重的低血压和心动过速是由于气球膨胀引起的，并且在手术过程中发生了一次心脏骤停。术后皮下血肿3例，尿路感染13例，住院期间死亡2例。 24名患者（8.1％）因新的疼痛事件而返回，23名患者报告了新的疼痛性骨折。球囊后凸成形术是治疗疼痛的椎体压缩性骨折的一种有效而有效的方法。后凸成形术后患者的快速动员以及迅速重新融入社会环境都是可能的。与其他外科手术相比，尤其是在平均年龄为75岁的患者中，球囊后凸成形术似乎具有一些优势。然而，该手术仍有可能引起严重的并发症，应由训练有素的人员进行。关键词：球囊后凸成形术，结局，并发症，椎体压缩性骨折。

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