Em um artigo publicado recentemente na revista Radiology, quarenta e seis casos de colapso vertebral osteoportico (27 torcicos e 19 lombares) foram tratados com vertebroplastia percutnea em posio de hiperlordose.
A reducibilidade da cifose foi estimada antes do procedimento atravs da diferena angular entre a posio neutra e de hiperlordose. A reduo efetiva foi a diferena angular nas posies neutras antes e aps a vertebroplastia. A reduo ( 14; mdia, 6.43) foi obtida nos casos de reducibilidade estimada maior que 5o (31 casos, 67%), uma reduo mdia de 34 % (6.5 de 19.1). Um nvel significativamente maior de reduo da cifose foi observado nos casos de fratura intravertebral (20 casos, 43 %) na hiperlordose do que nos casos sem fratura (7.2 vs 4.9; P < .01).
Os autores concluram que a vertebroplastia pode reduzir a cifose causada por colapso vertebral localizado; a mobilidade e a presena de fratura intravertebral sugerem esta possibilidade.
Osteoporotic Vertebral Collapse: Percutaneous Vertebroplasty and Local Kyphosis Correction - Radiology 2004; 233: 891-898
Osteoporotic Vertebral Collapse: Percutaneous Vertebroplasty and Local Kyphosis Correction1
Robert Y. Carlier, MD, Haleh Gordji, MD, Dominique M. Mompoint, MD, Nicolas Vernhet, MD, Antoine Feydy, MD and Christian Valle, MD
1 From the Department of Diagnostic Imaging, Hpital Raymond Poincar, 104 Blvd Raymond Poincar, 92380 Garches, France. Received March 21, 2003; revision requested June 13; final revision received March 9, 2004; accepted May 12. Address correspondence to R.Y.C. (e-mail: robert.carlier@rpc.ap-hop-paris.fr).
Forty-six cases of osteoporotic vertebral collapse (27 thoracic, 19 lumbar) were treated by means of percutaneous vertebroplasty in a hyperlordosis position. Institutional review board approval and informed consent were obtained. Kyphosis reducibility was preprocedurally estimated from the angular difference between neutral and hyperlordosis positions. Effective reduction was the angular difference in neutral positions before and after vertebroplasty. Reduction (
14; mean, 6.43) was obtained in cases with estimated reducibility greater than 5 (31 cases, 67%), which is a 34% (6.5 of 19.1) mean reduction. A significantly greater level of kyphosis reduction was observed in cases with intravertebral clefts (20 cases, 43%) at hyperlordosis than in those without (7.2 vs 4.9; P < .01). Vertebroplasty may reduce kyphosis due to localized collapsed vertebrae; intravertebral mobility and cleft suggest this possibility
