Article

Vertebroplastia percutânea: opção de tratamento para a fratura vertebral osteoporótica

Arquivos de Neuro-Psiquiatria 01/2003; DOI: 10.1590/S0004-282X2003000400019
Source: DOAJ

ABSTRACT A vertebroplastia percutânea (VP) é procedimento minimamente invasivo que visa tratar a dor local decorrente de fratura do tipo compressão da coluna vertebral. A VP está indicada para o alívio da dor grave e incapacitante da coluna vertebral, em pacientes com fraturas vertebrais decorrentes de osteoporose, metástases (osteolíticas), mieloma e hemangioma agressivo. Analisamos os resultados da VP realizadas em 18 vértebras de 11 pacientes. Houve melhora acentuada da dor em 90,9% dos casos. O retorno às atividades habituais ocorreu em 77,8% até o primeiro mês. De acordo com os dados da literatura e em nossa casuística, a VP se mostrou opção terapêutica promissora nos casos selecionados.

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    ABSTRACT: Resumo -Objetivo: Avaliar a resposta terapêutica a longo prazo da vertebroplastia percutânea para o tratamento da dor decorrente de fraturas de corpo vertebral por osteoporose. Método: Foram realiza-das 26 vertebroplastias percutâneas em 15 pacientes com dor por fraturas osteoporóticas de corpo verte-bral, durante o período de julho de 2001 a maio de 2004. Imediatamente antes e após o procedimento, foi aferido o grau de dor de cada paciente com base em uma escala verbal álgica entre zero e dez. esta aferi-ção foi repetida a longo prazo, com um ano de intervalo, sendo ainda investigada a satisfação do pacien-te, a deambulação e as atividades diárias (escalas de cinco pontos). Resultados: observou-se que a maio-ria dos pacientes (n=13) apresentava escala verbal de dor entre 8 e 10 antes da vertebroplastia. Houve im-portante redução álgica no dia seguinte, com 9 pacientes apresentando ausência de dor e três pacientes escala álgica entre 1 e 4 (p<0,001). No acompanhamento a longo prazo, com um ano de intervalo, a me-lhora dos sintomas se manteve, sem diferença significativa na escala de dor, na deambulação e nas ativi-dades diárias. Quando questionados se fariam novamente este tratamento no caso de nova fratura ver-tebral, 14 pacientes responderam que sim. Conclusão: A vertebroplastia percutânea pode ocasionar im-portante melhora da dor em pacientes com fraturas osteoporóticas de corpo vertebral, quando bem sele-cionados, com boa resposta a longo prazo. PAlAvRAs-cHAve: vertebroplastia percutânea, osteoporose, fratura vertebral. percutaneous vertebroplasty for vertebral osteoporotic fractures: long term analysis ABsTRAcT -Objective: To assess the long-term efficacy of percutaneous vertebroplasty for the treatment of pain resulting from osteoporotic vertebral fractures. Method: 26 percutaneous vertebroplasty proce-dures were performed for osteoporotic vertebral fractures in 15 patients during the period between July 2001 and may 2004. Before and after the procedure, a 10-point scale of pain was obtained. These scale was repeated at long-term follow up in two different moments after the procedure with one year interval. Du-ring these moments, the satisfaction, ambulation and ability to perform activities of daily living (five-point scale) were also analyzed. Results: The majority of patients (n=13) presented the 10-point pain scale be-tween 8 and 10 before the percutaneous vertebroplasty. After the procedure, there was important impro-ve of the pain, and nine patients presented zero point-scale and three patients between 1 and 4 (p<0.001). At long-term follow up with one year interval, there was no significant difference between the pain sca-le, the ambulation and the ability to perform activities of daily living. Fourteen patients reported a future willingness to undergo the procedure for treatment in case of a new compression fracture. Conclusion: Percutaneous vertebroplasty can be a useful procedure for the treatment of pain and disability after se-condary osteoporotic vertebral fractures with durable results in selected patients.
    Arquivos De Neuro-psiquiatria - ARQ NEURO-PSIQUIAT. 01/2007; 65.
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    ABSTRACT: To assess the long-term efficacy of percutaneous vertebroplasty for the treatment of pain resulting from osteoporotic vertebral fractures. 26 percutaneous vertebroplasty procedures were performed for osteoporotic vertebral fractures in 15 patients during the period between July 2001 and May 2004. Before and after the procedure, a 10-point scale of pain was obtained. These scale was repeated at long-term follow up in two different moments after the procedure with one year interval. During these moments, the satisfaction, ambulation and ability to perform activities of daily living (five-point scale) were also analyzed. The majority of patients (n=13) presented the 10-point pain scale between 8 and 10 before the percutaneous vertebroplasty. After the procedure, there was important improve of the pain, and nine patients presented zero point-scale and three patients between 1 and 4 (p<0.001). At long-term follow up with one year interval, there was no significant difference between the pain scale, the ambulation and the ability to perform activities of daily living. Fourteen patients reported a future willingness to undergo the procedure for treatment in case of a new compression fracture. Percutaneous vertebroplasty can be a useful procedure for the treatment of pain and disability after secondary osteoporotic vertebral fractures with durable results in selected patients.
    Arquivos de Neuro-Psiquiatria 06/2007; 65(2B):482-7. · 0.83 Impact Factor

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