Yıl: 2010 Cilt: 20 Sayı: 4 Sayfa Aralığı: 464 - 469 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients

Öz:
Amaç: Vertebroplasti ve kifoplasti, vertebral kompresyon fraktürlerinin tedavisinde kullanılan minimal invaziv yöntemlerdir. Bu çalışmada, lokal anestezi altında ve perkütan olarak uyguladığımız vertebroplasti ve kifoplasti hastalarımızı sunmayı amaçladık.Yöntem ve Gereç: 2002 ile 2008 yılları arasında, osteoporoz, tümör ve travma nedeniyle vertebral kompresyon fraktürü gelişen 91 hastaya (toplam 112 vertebra) vertebroplasti veya kifoplasti yapıldı. Radyolojik ve rutin biokimyasal değerlendirmelerin ardından tüm hastalar lokal anestezi altında opere edildiler. Ortalama operasyon zamanı her vertebra için 20 dakika idi. Hastaların intoleransı sebebiyle hiçbir operasyon yarıda kalmadı ve biri dışında tüm hastalar operasyon günü ya da ertesi gün taburcu edildiler.Bulgular: Tüm hastalarda ciddi sırt ağrısı mevcuttu. Preoperatif ortalama Görsel Analog Skoru (GAS) 8,3 iken postoperatif değer 2,7 idi. Cisim yüksekliğinde %44, anterior duvar yüksekliğinde %32 artış elde edildi. Ortalama kifoz açısı 15,4 den 11,2 ye düştü. Dört hastada çimento sızması tespit edildi, bu hastalardan biri çimentonun epidural alana sızması nedeniyle açık operasyona dönüldü (dekompresyon ve stabilizasyon uygulandı). Başka komplikasyon izlenmedi.Sonuç: Vertebroplasti ve kifoplasti, perkütan ve lokal anestezi atında uygulanabilen, güvenli, efektif ve minimal invaziv yöntemlerdir. Bu sayede yaşlı hastalar genel anestezinin yol açabileceği komplikasyonlardan korunarak erken mobilize ve taburcu olabilirler.
Anahtar Kelime:

Konular: Cerrahi

Lokal anestezi altında uygulanan vertebroplasti ve kifoplastiler: 91 hastanın değerlendirilmesi

Öz:
Aim: Vertebroplasty (VP) and kyphoplasty (KP) are minimally invasive methods for the treatment of vertebral compression fractures (VCF). In this study, we aimed to present our experience with VP and KP performed under local anesthesia and percutaneously.Material and Methods: Between 2002 and 2008, 91 patients (total 112 vertebrae) with VCF due to osteoporosis, tumor and trauma underwent VP or KP. After radiological and routine evaluations, all patients were operated under local anesthesia. Mean operation time was 20 minutes per vertebrae. We never stopped the operation because of intolerance of any patient and all of them were discharged on the day of operation or the next day except one.Results: All patients had severe back pain. Mean preoperative Visual Analogue Scale (VAS) score for pain was 8.3 and the mean postoperative value was 2.7. Mean anterior wall and mid-vertebral body heights increased by 32% and 43%, respectively. The mean kyphotic angle decreased from 15.4 to 11.2. Cement leakage was observed in 4 patients and one of them underwent an open operation (decompression and stabilization) because of cement leakage to the epidural space. There was no other complication.Conclusion: Vertebroplasty and kyphoplasty are safe, effective and minimally invasive procedures. Elderly patients can thefore avoid the potential complications of general surgery and be mobilized and discharged early.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Anselmetti GC, Corrao G, Monica PD, Tartaglia V, Monca A, Eminefendic H, Russo F, Tasetti I, Regge D: Pain relief following percutaneous vertebroplasty: Results of a series of 283 consecutive patients treated in a single instution. Cardiovasc Intervent Radiol 30: 441-447, 2007
  • 2. Chen KY, Ma HI, Chiang YH: Percutaneous transpedicular vertebroplasty with polymethyl methacrylate for pathological fracture of the spine. Journal of Clinical Neuroscience 16: 1300-1304, 2009
  • 3. Costa F, Ortolina A, Canlia A, Sassi M, De Santis A, Borroni M, Savoia G, Fornari M: Efficacy of treatment with percutaneous vertebroplasty and kyphoplasty for traumatic fracture of thoracolumbar junction. J Nurosurg Sci 53:13-17, 2009
  • 4. Frost EAM, Johnson DM: Anesthetic considerations during vertebroplasty, kyphoplasty and intradiscal electrothermal therapy. International Anesthesiology Clinics 47(2):45-55, 2009
  • 5. Gaitanis IN, Hadjipavlou AG, Katonis PG, Tzermiadionis MN, Pasku DS, Patwardhan AG: Balloon kyphoplasty for the treatment of pathological vertebral compressive fractures. Eur Spine J 14:250-260, 2005
  • 6. Galibert P, Deromond H, Rosat P, Le Gars D: Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty: Neurochirurgie 33:166-168, 1987
  • 7. Hannallah M, Gibby E, Watson V: Fluoroscopy-guided, small dose spinal anesthesia for kyphoplasty, a collaborative effort between the anesthesiologist and interventional radiologist. Anesth Analg 106(4): 1329-1330, 2008
  • 8. Heini PF, Orler R: Kyphoplasty for treatment of osteoporotic vertebral fractures. Eur Spine J 13:184-192, 2004
  • 9. Khanna AJ, Reinhardt MK, Togawa D, Lieberman IH: Functional outcomes of kyphoplasty for the treatment of osteoporotic and osteolytic vertebral compression fractures. Osteoporos Int 17:817-826, 2006
  • 10. Kim HW, Song JW, Kwan A, Kim H: Extreme multi-level percutaneous vertebroplasty for newly developed multiple adjacent compression fractures. J Korean Neurosurg Soc 45:378-380, 2009
  • 11. Korovessis P, Hadjipavlou A, Repantis T: Minimal invasive short posterior instrumentation plus balloon kyphoplasty with calcium phosphate for burst and severe compression lumbar fractures. Spine 33(6):658-667, 2008
  • 12. Krueger A, Bliemel C, Zettl R, Ruchholtz S: Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: A systematic review of the literature. Eur Spine J 18:1257-1265, 2009
  • 13. Lavelle WF, Khaleal MA, Cheney R, Demers E, Carl AL: Effect of kyphoplasty on survival after vertebral compression fractures. The Spine J 8;763-769, 2008
  • 14. Lee B, Franklin I, Lewis JS, Coombes C, Leonard R, Gishen P, Stebbing J: The efficacy of percutaneous vertebroplasty for vertebral metastases associated with solid malignancies. Eur J Cancer 45:1597-1602, 2009
  • 15. Lee MJ, Dumonski M, Cahill P, Stanley T, Park D, Singh K: Percutaneous treatment of vertebral compression fractures. Spine 34(11): 1228-1232, 2009
  • 16. Lim BS, Chang UK, Youn SM: Clinical outcomes after percutaneous vertebroplasty for pathologic compression fractures in osteolytic metastatic spinal disease. J Korean Neurosurg Soc 45:369-374, 2009
  • 17. Majd ME, Farley S, Holt RT: Preliminary outcomes and efficacy of the first 360 consecutive kyphoplasties for the treatment of painful osteoporotic vertebral compression fractures. Spine J 5:244-255, 2005
  • 18. Mohit AA, Orr RD: Osteoporotic kırıklarda perkütan vertebral güçlendirme. Current Opinion in Orthopaedics, Turkish Edition 2(2):59-65, 2007
  • 19. Pflugmacher R, Taylor R, Agarwal A, Melcher I, Disch A, Haras NP, Klosterman C: Balloon kyphoplasty in the treatment of metastatic disease of the spine: A 2 year prospective evaluation. Eur Spine J 17:1042-1048, 2008
  • 20. Phillips FM: Minimally invasive treatments of osteoporotic vertebral compression fractures. Spine 28(155): 45-53, 2003
  • 21. Phillips FM, Erling H, Campbell-Hupp M, McNally T, Wetzel T, Gupta P: Early radiographic and clinical results of balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures. Spine 28(19):2260-2267, 2003
  • 22. Ryu KS, Park CK: The prognostic factors influencing on the therapeutic effect of percutaneous vertebroplasty in treating osteoporotic vertebral compression fractures. J Korean Neurosurg Soc 45:16-23, 2009
  • 23. Schubert A, Deogaonkar A, Lotto M, Niezguda J, Luciano M: Anesthesia for minimally invasive cranial and spinal surgery. J Neurosurg Anesthesiol 18(1):47-56, 2006
  • 24. Sesay M, Dousset V, Liguoro D, Pehourca F, Caille JM, Mauratte P: Intraosseous lidocaine provides effective analgesia for percutaneous vertebroplasty of osteoporotic fractures. Can J Anaesth 49:137-143, 2002
  • 25. Taş I, Hepgüler S, Zileli M, Çağlı S, İşlekel S: Osteoporotik vertebral kompresyon kırıklarının tedavisinde vertebroplasti ve kifoplasti. Osteoporoz Dünyasından 10(4):147-152, 2004
  • 26. Taylor RS, Taylor RJ, Fritzell P: Balloon kyphoplasty and vertebroplasty for vertebral compression fractures. Spine 31(23): 2747-2755, 2006
  • 27. Watts NB, Harris ST, Genant HK: Treatment of painful osteoporotic vertebral fractures with percutaneous vertebroplasty or kyphoplasty. Osteoporos Int 12:429-437, 2001
  • 28. White SM: Anaesthesia for percutaneous vertebroplasty. Anaesthesia 57:1229-1230, 2002
  • 29. Zhang R, Tao C, Yochum TR: Use of percutaneous vertebroplasty for intractable back pain associated with compression fracture in an 80 year-old female. J Manipulative Physiol Ther 31:319-322, 2008
APA çağlı m, IŞIK H, Zileli M (2010). Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients. , 464 - 469.
Chicago çağlı mehmet sedat,IŞIK HASAN SERDAR,Zileli Mehmet Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients. (2010): 464 - 469.
MLA çağlı mehmet sedat,IŞIK HASAN SERDAR,Zileli Mehmet Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients. , 2010, ss.464 - 469.
AMA çağlı m,IŞIK H,Zileli M Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients. . 2010; 464 - 469.
Vancouver çağlı m,IŞIK H,Zileli M Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients. . 2010; 464 - 469.
IEEE çağlı m,IŞIK H,Zileli M "Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients." , ss.464 - 469, 2010.
ISNAD çağlı, mehmet sedat vd. "Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients". (2010), 464-469.
APA çağlı m, IŞIK H, Zileli M (2010). Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients. Turkish Neurosurgery, 20(4), 464 - 469.
Chicago çağlı mehmet sedat,IŞIK HASAN SERDAR,Zileli Mehmet Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients. Turkish Neurosurgery 20, no.4 (2010): 464 - 469.
MLA çağlı mehmet sedat,IŞIK HASAN SERDAR,Zileli Mehmet Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients. Turkish Neurosurgery, vol.20, no.4, 2010, ss.464 - 469.
AMA çağlı m,IŞIK H,Zileli M Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients. Turkish Neurosurgery. 2010; 20(4): 464 - 469.
Vancouver çağlı m,IŞIK H,Zileli M Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients. Turkish Neurosurgery. 2010; 20(4): 464 - 469.
IEEE çağlı m,IŞIK H,Zileli M "Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients." Turkish Neurosurgery, 20, ss.464 - 469, 2010.
ISNAD çağlı, mehmet sedat vd. "Vertebroplasty and kyphoplasty under local anesthesia: Review of 91 patients". Turkish Neurosurgery 20/4 (2010), 464-469.