후방 기기고정 부위 최상부 추체의 압박골절에서 경피적 척추경주위 접근을 통한 척추체 성형술 - 증례 보고 = Percutaneous Para-Pedicular Vertebroplasty for an Uppermost Instrumented Vertebral Fracture - A Case Report -

다국어 초록 (Multilingual Abstract)

Study Design: Case report.
Objectives: This case report presents a surgical technique used to perform vertebral anterior column stabilization in an elderly male patient who had recently been diagnosed with an uppermost instrumented vertebral fracture (IVF) at the site of previous posterior lumbar instrumented fusion (PIF).
Summary of Literature Review: Although conservative treatment is also used for IVF, the proximal junction of PIF is an area where the compression load is concentrated biomechanically, so the uppermost IVF often requires surgical treatment. This may require fixation of extended segments and more surgical morbidity.
Materials and Methods: A 73-year-old male patient who had undergone PIF from L2 to L5 more than 20 years previously was recently diagnosed with uppermost IVF without a traumatic event. He complained of persistent back pain even after 2 months of conservative treatment. He ultimately underwent percutaneous vertebroplasty through the parapedicular approach.
Result: The patients showed a favorable outcome at a 1-year follow-up.
Conclusions: Percutaneous vertebroplasty through the parapedicular approach for uppermost IVF at the site of a previous PIF might be a feasible and less invasive alternative.

국문 초록 (Abstract)

연구 계획: 증례보고목적: 본 연구의 목적은 후방 기기 고정부위 최상부 추체의 압박 골절에서 척추경 주위 (parapedicular) 접근을 통한 경피적 척추체 성형술을 시행한 증례보고이다.
선행 연구문헌의 요약: 후방 기기 고정부위 추체에서 발생한 압박골절(Instrumented vertebral fracture; IVF)은 보존적 치료를 선택하는 경우가 많다. 그러나 후방 기기 고정의 근위 이행부의 경우는 생체역학적으로 압축 부하가 집중되는 부위이기 때문에 최상부 IVF의 경우 장분절 고정술을 요할 수 있다. 하지만, 이는 장분절 고정술과 높은 수술적 이환을 요한다.
대상 및 방법: 20여년전 제 2요추-5요추 간 후방 요추 기기 유합술을 시행 받은 73세 남자 환자에서, 저명한 외상력 없이 최상부 기기고정 요추 골절로 진단되었다. 이에 2개월간 보존적인 치료를 시행했음에도 지속적인 요통과 추체의 점진적인 높이 소실이 관찰되었다. 환자는 척추경 주위 (parapedicular) 접근을 통한 경피적 척추체 성형술을 시행받았다.
결과: 척추체 성형술 시행 후 일 년간의 추적관찰에서 좋은 결과를 보였다.
결론: 최상부 IVF에서, 척추경 주위 접근을 통한 경피적 척추체 성형술은 비침습적이고 실현 가능한 하나의 대안으로 고려될 수 있다.
약칭 제목: 척추경주위접근적 척추성형술

참고문헌 (Reference)

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