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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Oh, Younggyu (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) Lee, Byungjou (Department of Neurosurgery, Inje University Ilsan Paik Hospital, Neuroscience & Radiosurgery hybrid Research Center, Inje University College of Medicine) Lee, Subum (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) Kim, Junghwan (Department of Orthopaedic Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) Park, Jinhoon (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제62권 제5호
발행연도
2019.1
수록면
594 - 602 (9page)

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Objective : Although surgical intervention, such as percutaneous vertebroplasty (PVP), is the standard treatment for osteoporotic vertebral compression fractures (OVCFs), its effectiveness and safety are unclear. Therefore, this study compared the safety and efficacy of conservative treatment with that of PVP for acute OVCFs. Methods : Patients with single-level OVCFs who were treated conservatively with a transdermal fentanyl patch (TFP) or with PVP between March 2013 and December 2017 and followed-up for more than 1 year were retrospectively evaluated. Patients with pathologic fractures, fractures of more than two columns, or a history of PVP were excluded. Clinical outcomes (visual analog scale [VAS] scores) and radiographic factors were evaluated, including changes in the compression rate of the corresponding vertebral body at onset and after 12 months, sagittal Cobb angle at onset and after 6 and 12 months, and the incidence of adjacent compression fractures. Results : Of the 131 patients evaluated, 75 were treated conservatively using TFPs and 56 underwent PVP. We divided the patients into TFP and PVP groups. Their baseline characteristics (including sex, level of fracture, and bone mineral density T-scores) were similar, but the TFP group was significantly younger. The overall VAS score for pain showed a greater decrease during the first month (1 week after PVP) in the PVP group but remained similar in the two groups thereafter. The compression rate after 12 months increased in the TFP group but decreased in the PVP group. Five patients in the PVP group, but none in the TFP group, experienced adjacent compression fractures within 12 months. Conclusion : We compared clinical and radiological outcomes between the TFP and PVP groups. The immediate pain reduction effect was superior in the PVP group, but the final clinical outcome was similar. Although the PVP group had a better-preserved compression rate than the TFP group for 1 year, the development of adjacent fractures was significantly higher. Although TFPs seemed to be beneficial in reducing the failure rate of conservative treatment, the possibility of side effects (22.6%, 17 out of 75 patients, in this study) should be carefully monitored.
#Fractures, Compression #Vertebroplasty #Conservative treatment

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참고문헌 (26)

참고문헌 신청
Anselmetti GC / 2013 / Criteria for the appropriate treatment of osteoporotic vertebral compression fractures / Pain Physician 16:E519~E530 google schola 최준호 / 2017 / The Effcacy of Fentanyl Transdermal Patch as the First-Line Medicine for the Conservative Treatment of Osteoporotic Compression Fracture / Korean Journal of Neurotrauma 13(2):130~136 dbpia Cui R / 2016 / Assessment risk of osteoporosis in Chinese people: relationship among body mass index, serum lipid profiles, blood glucose, and bone mineral density / Clin Interv Aging 11:887~895 google schola Grond S / 2000 / Clinical pharmacokinetics of transdermal opioids: focus on transdermal fentanyl / Clin Pharmacokinet 38:59~89 google schola Han S / 2011 / Percutaneous vertebroplasty versus balloon kyphoplasty for treatment of osteoporotic vertebral compression fracture: a meta-analysis of randomised and nonrandomised controlled trials / Int Orthop 35:1349~1358 google schola

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