Resultados anatomofuncionales de vertebroplastia en fractura vertebral osteopoporótica dorsolumbar
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2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Antecedentes: Las fracturas vertebrales por compresión son causada principalmente por osteoporosis. En ancianos frágiles se observa con mayor frecuencia el fracaso del tratamiento conservador. En los últimos años, técnicas mínimamente invasivas como la vertebroplastia percutánea (VP) y la cifoplastia percutánea (CP) se introdujeron para mejorar y reducir estos problemas. El tiempo medio de operación en vertebroplastia es significativamente más corto en comparación con la cifoplastia y representa menor costo operativo e instrumental, así como la necesidad de menor curva de aprendizaje para realizarla. Objetivo: Establecer la correlación existente entre el restablecimiento del ángulo cifótico y los resultados anatomo - funcionales posterior a vertebroplastia. Métodos: Investigación cuantitativa, descriptiva, correlacional, no experimental, retrospectiva, transversal donde se estudiaron 45 pacientes que acuden a la consulta de Traumatología del Hospital Alcívar con diagnóstico de fractura vertebral osteoporótica. Resultados: Encontramos un valor promedio de Oswestry funcional preoperatorio de 56,89 y posoperatorio de 28,44 existiendo una importante diferencia. La mejoría del dolor fue estadísticamente significativa al comparar el promedio de escala de dolor EVA prequirúrgico 6,9333 con el posquirúrgico 4,8444. Se pudo evidenciar mínima discapacidad en el 53% de los casos y tolerancia al dolor en el 51% de los casos, con cifosis residual entre 5 y 15 grados. La complicación más frecuente fue la fuga de cemento en el 20% de los casos. Conclusiones: El restablecimiento del ángulo cifótico, mediante vertebroplastia mejora la función, el dolor y disminuye el tiempo de recuperación, con pocas complicaciones.
Palabras clave: Vertebroplastia, osteoporosis, ángulo cifótico, fractura vertebral, cemento óseo
Background: Vertebral compression fractures are mainly caused by osteoporosis. In frail elderly, failure of conservative treatment is observed more frequently. In recent years, minimally invasive techniques such as percutaneous vertebroplasty (PV) and percutaneous kyphoplasty (CP) have been introduced to improve and reduce these problems. The mean operating time in vertebroplasty is significantly shorter compared to kyphoplasty and represents lower operating and instrument costs, as well as the need for a shorter learning curve to perform it. Objective: To establish the existing correlation between the restoration of the kyphotic angle and the anatomical and functional results after vertebroplasty. Methods: Quantitative, descriptive, correlational, non-experimental, retrospective, cross-sectional research where 45 patients attending the Alcívar Hospital Traumatology consultation with a diagnosis of osteoporotic vertebral fracture were studied. Results: We found an average preoperative functional Oswestry value of 56.89 and a postoperative value of 28.44, with an important difference. The pain improvement was statistically significant when comparing the average presurgical VAS pain scale 6.9333 with the post-surgical 4.8444. Minimal disability could be evidenced in 53% of cases and pain tolerance in 51% of cases, with residual kyphosis between 5 and 15 degrees. The most frequent complication was cement leakage in 20% of cases. Conclusions: Restoration of the kyphotic angle through vertebroplasty improves function, pain and decreases recovery time, with few complications. Keywords: Vertebroplasty, osteoporosis, kyphotic angle, vertebral fracture, bone cement
Background: Vertebral compression fractures are mainly caused by osteoporosis. In frail elderly, failure of conservative treatment is observed more frequently. In recent years, minimally invasive techniques such as percutaneous vertebroplasty (PV) and percutaneous kyphoplasty (CP) have been introduced to improve and reduce these problems. The mean operating time in vertebroplasty is significantly shorter compared to kyphoplasty and represents lower operating and instrument costs, as well as the need for a shorter learning curve to perform it. Objective: To establish the existing correlation between the restoration of the kyphotic angle and the anatomical and functional results after vertebroplasty. Methods: Quantitative, descriptive, correlational, non-experimental, retrospective, cross-sectional research where 45 patients attending the Alcívar Hospital Traumatology consultation with a diagnosis of osteoporotic vertebral fracture were studied. Results: We found an average preoperative functional Oswestry value of 56.89 and a postoperative value of 28.44, with an important difference. The pain improvement was statistically significant when comparing the average presurgical VAS pain scale 6.9333 with the post-surgical 4.8444. Minimal disability could be evidenced in 53% of cases and pain tolerance in 51% of cases, with residual kyphosis between 5 and 15 degrees. The most frequent complication was cement leakage in 20% of cases. Conclusions: Restoration of the kyphotic angle through vertebroplasty improves function, pain and decreases recovery time, with few complications. Keywords: Vertebroplasty, osteoporosis, kyphotic angle, vertebral fracture, bone cement
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Vertebroplastia, Osteoporosis, Fracturas de la columna vertebral, Epidemiología descriptiva, Estudios retrospectivos, Hospital Alcívar, Cantón Guayaquil, Ecuador