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R. Pestana, et al.: Cifoplastia no Tratamento da Dor
tratamento específico (nível de recomenda- 10. Bouza C, López T, Magro A, Navalpotro L, Amate JM. Efficacy
ção: inconclusivo). and safety of balloon kyphoplasty in the treatment of vertebral
compression fractures: a systematic review. Eur Spine J.
Estas recomendações foram o resultado de 2006;21:1-18.
revisão sistemática deste grupo de trabalho rea- 11. Hadjipavlou AG, Tzermiadianos MN, Katonis PG, Szpalski M. Per-
lizada entre março de 2009 e Fevereiro de 2010, cutaneous vertebroplasty and balloon kyphoplasty for the treatment
e foram aprovadas pelo comité de medicina of osteoporotic vertebral compression fractures and osteolytic tu-
mours. J Bone Joint Surg Br. 2005;87:1595-604.
baseada na evidência da AAOS. As implicações 12. Bouza C, López-Cuadrado T, Cediel P, Saz-Parkinson Z, Amate JM.
clínicas destas guidelines são as seguintes: Balloon kyphoplasty in malignant spinal fractures: a systematic re-
view and meta-analysis. BMC Palliative Care. 2009;8:12.
– Em doentes adultos neurologicamente ínte- 13. Fourney DR, Schomer DF, Nader R, et al. Percutaneous vertebro-
gros com FCV osteoporóticas, a vertebro- plasty and kyphoplasty for painful vertebral body fractures in cancer
plastia não reduz significativamente a dor patients. J Neurosurg. 2003;98:21-30.
ou melhora a capacidade funcional, pelo 14. Kose KC, Cebesoy O, Akan B, Altinel L, Dincer D, Yazar T. Func-
tional results of vertebral augmentation techniques in pathological
que não está recomendada. vertebral fractures of myelomatous patients. J Natl Med Assoc.
– Em doentes adultos neurologicamente ínte- 2006;98:1654-8.
gros com FCV osteoporóticas, as opções 15. Pflugmacher R, Schulz A, Schroeder RJ, Schaser KD, Klostermann
terapêuticas incluem calcitonina, bloqueio CK, Melcher I. A prospective two-year follow-up of thoracic and
lumbar osteolytic vertebral fractures caused by multiple myeloma
de raízes nervosas e cifoplastia. treated with balloon kyphoplasty. Z Orthop Ihre Grenzgeb.
2007;145:39-47.
16. Pflugmacher R, Taylor R, Agarwal A, et al. Balloon kyphoplasty in
conclusões the treatment of metastatic disease of the spine: a 2-year prospec-
tive evaluation. Eur Spine J. 2008;17:1042-8.
A cifoplastia tem-se mostrado segura e efi- 17. Arregui R, Martínez-Quiñones JV, Aso-Escario J, Aso-Vizan J.
caz no tratamento de FCV osteoporóticas e Papel del refuerzo vertebral mediante cifoplastia en el tratamien-
osteolíticas, hemangiomas vertebrais expansi- to de las fracturas dorsolumbares de índole no osteoporótico.
vos e em alguns casos seleccionados de frac- Revisión del tema y análisis de 40 casos. Neurocirugía.
2008;19:537-50.
turas agudas traumáticas, isoladamente ou em 18. Acosta FL, Aryan HE, Taylor WR, Ames CP. Kyphoplasty-augmented
combinação com instrumentação posterior. short-segment pedicle screw fixation of traumatic lumbar burst frac-
Constitui uma importante arma terapêutica em tures: initial clinical experience and literature review. Neurosurg
Focus. 2005;18.
patologias onde os tratamentos convencionais 19. Cho DY, Lee WY, Sheu PC. Treatment of thoracolumbar burst
eram muitas vezes falíveis. Não sendo o nível fractures with polymethylmethacrylate vertebroplasty and short-
de evidência para este tratamento ainda o de- segment pedicle screw fixation. Neurosurgery. 2003;53:
1354-61.
sejável, não podemos deixar de considerá-lo 20. Jones JO, Bruel BM, Vattam SR. Management of painful vertebral
adequado a muitas situações clínicas, tendo hemangiomas with kyphoplasty: a report of two cases and a litera-
sempre presente que a selecção criteriosa das ture review. Pain Physician. 2009;12:E297-303.
indicações é fundamental no sucesso terapêu- 22. Atalay B, Caner H, Yilmaz C, Altinors N. Sacral kyphoplasty for re-
lieving pain caused by sacral hemangioma. Spinal Cord. 2006;44:
tico. Tal como em estudos anteriores, parece 196-9.
ser cada vez mais evidente a sua superiorida- 23. Zapalowicz K, Skora P, Myslinski R, Karnicki F, Radek A. Balloon
de em relação à vertebroplastia, não só na kyphoplasty for painful C-7 vertebral hemangioma. Case report. J
Neurosurg Spine. 2008;8:458-61.
eficácia clínica, como também no perfil de se- 21. Hadjipavlou A, Tosounidis T, Gaitanis I, Kakavelakis K, Katonis P.
gurança. Balloon kyphoplasty as a single or as an adjunct procedure for the
management of symptomatic vertebral haemangiomas. J Bone Joint
Surg (Br). 2007;89-B:495-502.
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