Percutaneous vertebroplasty for maintenance hemodialysis patients with thoracolumbar vertebral compression fractures : a case report of four cases

キーワード:経皮的椎体形成術,胸腰椎圧迫骨折,維持血液透析,骨粗鬆症,慢性腎臓病骨・ミネラル代謝異常 〈要旨〉 経皮的椎体形成術(PVP)は有痛性未治癒胸腰椎圧迫骨折における短期的な除痛効果が報告されているが,維持血 液透析患者での報告は少ない.今回,維持透析患者の圧迫骨折に対して PVPを施行した 4症例の患者背景・除痛効 果・合併症について検討した.いずれの症例も PVPに直接関連した大きな合併症はなく,施行後に著明な疼痛改善 を認め,離床時期も早かった.1症例では PVP施行後に 2回の圧迫骨折再発を呈し,計 3回の PVPを施行したが, いずれも除痛効果は高く,結果として ADL低下を防ぐことができた.PVPは維持透析患者に対しても安全で有効 な治療手段と考えられるが,圧迫骨折を繰り返す症例も多いことが示唆され,どの症例に PVPを行うべきかについ ては今後さらに症例を積み重ねて検討していく必要がある.

[1]  Amy P Abernethy,et al.  Validity and Reliability of the US National Cancer Institute's Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). , 2015, JAMA oncology.

[2]  T. Albert,et al.  Neurological deficit due to cement extravasation following a vertebral augmentation procedure. , 2013, Journal of neurosurgery. Spine.

[3]  J. Macho,et al.  Risk factors for the development of vertebral fractures after percutaneous vertebroplasty , 2013, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[4]  P. Anderson,et al.  Meta‐analysis of vertebral augmentation compared with conservative treatment for osteoporotic spinal fractures , 2013, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[5]  J. Macho,et al.  Effect of vertebroplasty on pain relief, quality of life, and the incidence of new vertebral fractures: A 12‐month randomized follow‐up, controlled trial , 2012, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[6]  G. Andersson,et al.  Comparing effects of kyphoplasty, vertebroplasty, and non-surgical management in a systematic review of randomized and non-randomized controlled studies , 2012, European Spine Journal.

[7]  K. Awai,et al.  Newly developed compression fractures after percutaneous vertebroplasty: comparison with conservative treatment , 2011, Japanese Journal of Radiology.

[8]  S. Sawada,et al.  Percutaneous vertebroplasty for osteoporotic compression fractures: long-term evaluation of the technical and clinical outcomes. , 2011, AJR. American journal of roentgenology.

[9]  J. Vries,et al.  Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial , 2010, The Lancet.

[10]  J. Lauritsen,et al.  Twelve-Months Follow-up in Forty-Nine Patients With Acute/Semiacute Osteoporotic Vertebral Fractures Treated Conservatively or With Percutaneous Vertebroplasty: A Clinical Randomized Study , 2010, Spine.

[11]  R. Buchbinder,et al.  A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures. , 2009, The New England journal of medicine.

[12]  J. Lauritsen,et al.  Percutaneous Vertebroplasty Compared to Conservative Treatment in Patients With Painful Acute or Subacute Osteoporotic Vertebral Fractures: Three-Months Follow-up in a Clinical Randomized Study , 2009, Spine.

[13]  Douglas Wardlaw,et al.  Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial , 2009, The Lancet.

[14]  Y. van der Graaf,et al.  Percutaneous vertebroplasty compared with optimal pain medication treatment: short-term clinical outcome of patients with subacute or chronic painful osteoporotic vertebral compression fractures. The VERTOS study. , 2007, AJNR. American journal of neuroradiology.

[15]  J. Hentz,et al.  Vertebral Endplate Fractures: An Indicator of the Abnormal Forces Generated in the Spine After Vertebroplasty , 2006, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[16]  E. Baskurt,et al.  Refracture with cement extrusion following percutaneous vertebroplasty of a large interbody cleft. , 2006, AJNR. American journal of neuroradiology.

[17]  D. Kallmes,et al.  New fractures after vertebroplasty: adjacent fractures occur significantly sooner. , 2006, AJNR. American journal of neuroradiology.

[18]  P. Heini,et al.  Asymptomatic diffuse pulmonary embolism caused by acrylic cement: an unusual complication of percutaneous vertebroplasty , 2003, Annals of the rheumatic diseases.

[19]  Joshua A Hirsch,et al.  Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. , 2003, Radiology.

[20]  S. Shapiro,et al.  Surgical removal of epidural and intradural polymethylmethacrylate extravasation complicating percutaneous vertebroplasty for an osteoporotic lumbar compression fracture. Case report. , 2003, Journal of neurosurgery.

[21]  J. Hebel,et al.  Percutaneous vertebroplasty for osteoporotic compression fractures: quantitative prospective evaluation of long-term outcomes. , 2002, Journal of vascular and interventional radiology : JVIR.

[22]  H. Genant,et al.  Treatment of Painful Osteoporotic Vertebral Fractures with Percutaneous Vertebroplasty or Kyphoplasty , 2001, Osteoporosis International.

[23]  Craig S. Wong,et al.  Increased risk of hip fracture among patients with end-stage renal disease. , 2000, Kidney international.