피스톤 방식 주입기를 이용한 척추체 성형술의 효과
Effect of Vertebroplasty with Bone Filler Device and Comparison with Balloon Kyphoplasty
- 주제(키워드) vertebroplasty , kyphoplasty , bone filler , compression fracture , bone cement
- 발행기관 아주대학교
- 지도교수 조기홍
- 발행년도 2013
- 학위수여년월 2014. 2
- 학위명 석사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000016384
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
BACKGROUND CONTEXT: Vertebroplasty and kyphoplasty are popular procedures for osteoporotic vertebral compression fractures. Although the kyphoplasty has a superior effect, it destroys normal vertebral trabecular structure and it has a higher cost. PURPOSE: To analyze vertebroplasty with a bone filler device compared with conventional kyphoplasty. STUDY DESIGN: A cross-sectional study for comparison of two operation groups. PATIENT SAMPLE: Two-hundred twenty-two patients treated from January 2008 to October 2012 OUTCOME MEASURES: Vertebral height, compression ratio, and segmental Cobb’s angle were measured in preoperative and postoperative lateral X-rays. METHODS: One hundred ninety-five patients were included after exclusion of 27 patients. One level fractures numbered 169 (86.7%) cases and two level fractures numbered 26 (13.3%). A total of 221 vertebral levels were analyzed consequently. Statistical analysis was performed to identify significant differences between the two groups. RESULTS: Vertebral height and compression ratio had stronger correlations than did segmental Cobb’s angle. The compression ratio was the most influential parameter among the three variables. Adjusted postoperative compression ratio was not significantly different between the two operation groups, whereas adjusted postoperative vertebral height and segmental Cobb’s angle differed significantly (p < 0.05). Bone cement leakage rates did not differ (p < 0.05). Bone cement distribution was spongy type in the majority of the vertebroplasty group (94.5%), but only spongy type in 42.0% of the kyphoplasty group. High bone densitometry (BMD) readings and long period from diagnosis to operation were significant risk factors for bone cement leakage among preoperative conditions. CONCLUSION: Compared with kyphoplasty, vertebroplasty with a bone filler device could achieve equivalent compression reduction and bone cement leakage rate, as well as greater sponge-type bone cement distribution, which were advantages over conventional vertebroplasty and kyphoplasty.
more목차
ABSTRACT i
TABLE OF CONTENTS iii
LIST OF FIGURES iv
LIST OF TABLES v
I. INTRODUCTION 1
II. MATERIALS AND METHODS 3
A. Inclusion and Exclusion Criteria 3
B. Subjects 3
C. Measurement 3
D. Surgical technique 4
E. Statistical Analysis 4
III. RESULT 6
IV. DISCUSSION 16
A. Vertebral height, compression ratio, and segmental Cobb’s angle 16
B. Equality of preoperative variables and adjusted postoperative variables 16
C. Intravertebral cleft and bone cement distribution 17
D. Bone cement volume 18
E. Bone cement leakage rate 19
F. Leakage risk factors due to preoperative conditions 20
G. Limitations 20
V. CONCLUSION 21
REFERENCES 22
국문 요약 27
