통증을 유발하는 골다공증성 척추골절의 최소 침습적 치료

Abstract

The consequences of osteoporotic vertebral compression fractures are pain, progressive vertebral collapse with resultant kyphosis, and systemic manifestations. Minimally invasive stabilization procedures such as vertebroplasty and balloon kyphoplasty have been introduced to treat for refractory pain due to these fractures. Vertebroplasty and kyphoplasty are new alternatives for the treatment of osteoporotic vertebral compression fractures. Both methods stabilize the fractured vertebra with polymethylmethacrylate cement to relieve pain and allow immediate mobilization. Kyphoplasty is an extension of vertebroplasty that uses an inflatable bone tamp to restore the vertebral body height while creating a cavity to be filled with bone cement. A large proportion of subjects had some pain relief both in vertebroplasty and kyphoplasty. Vertebral height restoration was possible using kyphoplasty and for a subset of patients using vertebroplasty. Cement leaks occurred in both groups but, the incidence of cement leakage in kyphoplasty is lower than that of the vertebroplasty. Vertebroplasty and kyphoplasty are safe and effective procedures. Good short-term results have been reported following both vertebroplasty and kyphoplasty for the painful osteoporotic vertebral fractures. Severe complications result from bone cement leakage into the spinal canal or the vascular system have been reported but the incidence was very rare. Both vertebroplasty and kyphoplasty offer therapeutic benefit significantly reducing pain and improving mobility in patients with vertebral fracture without significant differences between groups in term of quality. While early results are promising, more research is needed to better understand the log-term effects of both procedures on the human spine. 골다공증성 척추 골절은 임상에서 흔히 접하는 질환으 로 고령화 사회로 진입하면서 그 중요성은 더욱 증가 하고 있다. 많은 경우 초기에 증상이 없고 신장 감소와 허리가 굽는 등의 변화를 보이며 통증 등의 증상이 유발되더라도 투약과 활동 제한, 보조기 착용 등으로 치료되는 경우가 많다. 그러나 증상을 심하게 유발하는 골다공증성 척추 골절은 노령층의 활동장애 및 사망률의 주요한 원인으로서(1, 2), 결과적으로 통증과 함께 추체 함몰이 진행하면서 척추 후만 변형 및 전신 증상이 발생하고 삶의 질이 떨어지며 우울증도 발생한다고 알려져 있다(3).