椎体形成術の動向

Vertebroplasty for Vertebral Compression Fracture : Indications,Technique,Clinical Application

はじめに

　脊椎椎体骨折は骨粗鬆症が関連する骨折の中で最も発生頻度が高く，高齢者のQOLを低下させる代表的疾患である。これらを改善させる治療として，椎体形成術が近年着目を浴びている^1，2）。本稿では，脊椎圧迫骨折に対する椎体形成術の適応と実際，治療成績，問題点を述べる。

Abstract

　Patients with painful osteoporotic vertebral compression fractures (VCF) had been typically managed with conservative therapy.　Since its introduction,percutaneous vertebroplasty (PV),a minimally invasive therapeutic modality,has been widely used for stabilizing osteoporotic VCFs and,subsequently,relieving the associated local back pain.　Numerous prospective and retrospective studies on PV have been published,and this therapy,has been reported to have a high clinical success rate.　A recent systematic literature review demonstrated the effectiveness of PV in 87% of the subjects in terms of pain relief as well as short- and long-term improvement of function.　Despite the apparent lack of evidence,nowadays PV is currently considered an accepted therapy in many centers and acknowledged as a useful additional option for the care of these patients with VCF.