후측방 접근법을 이용한 흉요추부 척추체 성형술

Abstract

Objective: Transpedicular percutaneous vertebroplasty has been widely used for the treatment of osteoporotic vertebral compression fractures. The authors introduce a novel method of approach by the posterolateral route for percutaneous vertebroplasty. Materials and Methods: A retrospective review was conducted on 30 consecutive patients with 42 vertebrae of acute osteoporotic thoracolumbar compression fractures treated from Mar. 2002 to May 2003 with percutaneous vertebroplasty using this approach. Pain response, volume of polymethylmethacrylate (PMMA), epidural leakage of PMMA, distribution of PMMA in vertebral body and complications were investigated. Results: Among 30 patients, 27 had marked to complete pain relief, 2 moderate pain relief and 1 no significant change during follow up period. A mean volume of PMMA injected by this unilateral approach was 5.8cc. Epidural leakage of PMMA was noted on 28 vertebrae(66.7%) on postoperative CT scan. All vertebrae except one injected by this method showed bilateral distribution of PMMA on postoperative CT scan. Minor complication (transient radicular pain) occured in 2(6.7%) patients. Conclusion: Unilateral posterolateral approach of percutaneous vertebroplasty was a safe and effective method for the treatment of acute osteoporotic thoracolumbar compression fractures.