高齢者の椎体骨折に対するハイドロキシアパタイトブロックを用いた経皮的椎体形成術の手術成績

Clinical Outcome of Percutaneous Vertebroplasty Using Hydroxyapatite Blocks for the Treatment of Vertebral Fracture in the Elderly

　65歳以上の高齢者の新鮮椎体骨折で偽関節への移行が疑われる画像所見の症例に対して，ハイドロキシアパタイト(HA)ブロックを用いた椎体形成術を施行し，1年以上経過した10例の手術成績を評価した．椎体高は術後2カ月以降初診時から約10％減で維持されていた．Sagittal indexは最終診察時に15°以上に増悪したのが2例あり，局所後弯の進行は抑制できていなかった．偽関節の発生はなかった．椎体形成術は今後さらに十分な初期安静と外固定を行った保存療法との比較検討が必要である．

　We reported the clinical outcome of percutaneous vertebroplasty with hydroxyapatite (HA) blocks for the treatment of thoracolumbar vertebral fracture (T11-L3) in the elderly.　The patients were able to walk a mean of 5.5 days after surgery.　Loss of the vertebral height had been maintained within 10％ at latest follow-up examination.　The Sagittal index revealed that vertebroplasty with HA blocks did not prevent the progression of local kyphotic deformity.　No intervertebral cleft was observed in the surgical treatment group at latest follow-up examination.　The results indicated that alternative strategies are required to prevent the progression of local kyphotic deformity.　Evaluation of vertebroplasty with HA blocks in a larger numbers of patients is warranted in comparison with conservative treatment that includes a period of bed rest and rehabilitation program with a hard brace.