2017 年 26 巻 4 号 p. 411-416
To evaluate the efficacy of percutaneous vertebroplasty (PVP) for malignant vertebral compression fractures with symptoms of neurological compression and the predictive factors for poor neurologic outcomes following PVP. Forty-three patients with malignant vertebral compression fractures and symptoms of neurological compression were treated with PVP, and were classified into two groups according to the American Spinal Injury Association (ASIA) impairment scale at the last follow-up. Data were collected, and the patients were followed up for more than three months after the procedure. Univariate and multivariate analyses were performed to evaluate predictive factors of poor neurological recovery. PVP were successful in all patients. Full recovery from (n = 2) or improvement of (n =16) neurological compression symptoms was achieved in 18 patients (Group A), and no improvement of neurological compression symptoms in 25 patients (Group B). Univariate analysis showed more PMMA leakage (p = 0.038) and less PMMA volume injection (p < 0.001) was associated with the poor neurological recovery, and multivariate analysis showed that less PMMA volume injection (p = 0.004) was an independent predictor of poor neurologic recovery. PVP should not be served as an effective treatment for malignant compression fractures with symptoms of neurological compression, and less PMMA volume injection was an independent predictor of a poor neurologic recovery.
