2018 年 3 巻 3 号 p. 115-120
Background and Purpose: During a percutaneous vertebroplasty (PVP) procedure, patients typically lie in the prone position. However, some elderly patients have difficulty in maintaining the prone position. Therefore, we aimed to investigate the safety and efficacy of PVP in a lateral decubitus position in patients experiencing difficulty in maintaining the prone position.
Materials and Methods: A total of 123 PVP procedures performed consecutively on 117 patients for symptomatic vertebral fractures caused by bone tumors or osteoporosis were studied. The patients were divided into prone (n=113) and decubitus groups (n=10) according to their positions during the PVP procedures. The factors related to the patients' background, procedures, therapeutic effects, and adverse events were compared between the 2 groups. Univariate analysis was performed using Student's t-test, Mann-Whitney's U-test, chi-squared test, or Wilcoxon signed-rank test.
Results: In the decubitus group, the average age was 6.7 years older (p<0.05), the average set-up time was 1.6 times longer (p<0.01), the average fluoroscopic exposure dose was 1.37 times greater (p<0.05), the average dose-length product of interventional computed tomography was 1.78 times greater (p<0.05), and mobility restoration on the 7th day after the PVP was less (p<0.05) compared to the prone group. There were no significant differences in bone cement leakage, pulmonary embolism, recurrence of compression fractures, or pain relief.
Conclusion: Although some disadvantages were observed, decubitus PVP seemed to be completed safely and successfully. Decubitus PVP can become a treatment option for patients with vertebral fractures and difficulty in maintaining the prone position.
