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2017 ; 23
(ä): 2879-2889
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gab.com Text
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A Retrospective Study of Percutaneous Balloon Kyphoplasty for the Treatment of
Symptomatic Schmorl s Nodes: 5-Year Results
#MMPMID28607331
Zhi-Yong S
; Huan Z
; Feng L
; Nan-Ning L
; Xiao-Yu Z
; Bin P
; Jun L
; Zhong-Lai Q
; Zhi-Ming Z
; Hui-Lin Y
Med Sci Monit
2017[Jun]; 23
(ä): 2879-2889
PMID28607331
show ga
BACKGROUND Despite literature supporting the efficiency of percutaneous balloon
kyphoplasty (PKP) in treating osteoporotic and malignant vertebral compression
fractures, few reports exist that document its use for treatment of symptomatic
Schmorl's nodes (SNs) refractory to conservative treatment. Patients with
symptomatic SNs could have pain in the vertebrae similar to an acute vertebral
compression fracture. MRI is very helpful in diagnosing symptomatic SNs when
x-ray and CT scan are unremarkable. In painful cases, the vertebrae bone marrow
around the SNs is hyperintense on T2-weighted subsequence. We evaluated the
long-term safety and effectiveness of PKP for the treatment of symptomatic SNs
not responding to conservative therapy. MATERIAL AND METHODS From January 2008 to
December 2012, 32 patients suffering from symptomatic SNs underwent 43 PKP
procedures. Outcome data, including mean height ratio of anterior and middle
vertebral body, Visual Analog Scale (VAS score) for pain measurement, Oswestry
Disability Indexes (ODI score) and SF-36 questionnaires for function measurement
were recorded preoperatively, postoperatively, and at one month, six months, two
years, and five years after treatment. RESULTS Thirty-two patients were treated
successfully with PKP. Clinically asymptomatic cement leakage was observed in
three (6.98%) of the treated vertebral bodies. The mean height ratio of anterior
and middle vertebral bodies changed from 98.2±1.6% preoperatively to 98.5±1.4%
postoperatively (p>0.05) and 98.3±1.5% preoperatively to 98.8±1.9%
postoperatively (p>0.05). The mean VAS scores, ODI score, and SF-36 scores for
physical function (PF), bodily pain (BF), social functioning (SF), and vitality
(VT) all showed significant improvements (p<0.05). During the 5-year follow-up,
the stabilization of the height of the vertebral body and functional improvements
were all maintained. CONCLUSIONS PKP is a safe and effective procedure for the
treatment of symptomatic SNs refractory to conservative therapy.