摘要
目的观察椎体内裂隙对椎体强化术后再发邻近椎体骨折(AVF)的影响。方法回顾性分析172例椎体强化术后骨质疏松性椎体压缩性骨折(OVCF)的资料,根据术前是否存在椎体内裂隙分为裂隙组(n=37)及对照组(n=135),比较2组术中资料及术后影像学特征,分析椎体内裂隙对AVF的影响。结果裂隙组AVF发生率(54.55%,24/44),明显高于对照组(23.21%,39/168,χ^2=16.39,P<0.01);其骨水泥团块状分布、骨水泥椎间盘渗漏及骨水泥-骨界面液体征发生率(84.1%、43.2%、63.6%)均高于对照组(60.0%、26.8%、23.8%,χ^2=8.82、4.45、25.34,P均<0.05)。裂隙组伤椎前缘压缩率>50%椎体AVF发生率(75.00%)明显高于≤50%椎体(42.86%,χ^2=4.24,P=0.04),而不同椎体内裂隙位置、成分间AVF发生率差异无统计学意义(χ^2=2.13、0.27,P均>0.05)。结论伴椎体内裂隙的OVCF患者经皮椎体强化术后再发AVF风险增加,对术前椎体压缩程度重、术后存在骨水泥团块状分布及骨水泥-骨界面液体征者尤应密切随访观察。
Objective To investigate the impact of intravertebral cleft on adjacent vertebral fracture(AVF)after percutaneous vertebral augmentation.Methods Data of 172 patients with osteoporotic vertebral compression fracture(OVCF)who underwent percutaneous vertebral augmentation were retrospectively analyzed.The patients were divided into intravertebral cleft group(n=37)and control group(n=135)according to the presence or absence of intravertebral cleft before operation.The operative information and postoperative imaging characteristics were compared between 2 groups,and the impact of intravertebral cleft on AVF was analyzed.Results The incidence of AVF after vertebral augmentation in intravertebral cleft group(54.55%,24/44)was significantly higher than that in control group(23.21%,39/168,χ^2=16.39,P<0.01).The incidence of cement solid pattern distribution,intradiscal cement leakage and bone cement-bone surface fluid sign in intravertebral cleft group(84.1%,43.2%and 63.6%)were all higher than those in control group(60.0%,26.8%,23.8%,χ^2=8.82,4.45,25.34,all P<0.05).In intravertebral cleft group,the incidence of AVF in vertebral body with anterior wall height decreased ratio>50%(75.00%)was significantly higher than in those≤50%(42.86%,χ^2=4.24,P=0.04),but there was no statistical difference of the incidence of AVF among different fracture locations nor components(χ^2=2.13,0.27,both P>0.05).Conclusion OVCF patients with intravertebral cleft are at increased risk of recurrence AVF after percutaneous vertebral augmentation,especially those with higher anterior wall height decreased ratio,postoperative bone cement mass distribution and bone cement-bone surface fluid signs and being required close follow-up observation.
作者
蔡金辉
刘庆余
阮耀钦
叶晧翊
伍志华
郭栋华
刘志锋
CAI Jinhui;LIU Qingyu;RUAN Yaoqin;YE Haoyi;WU Zhihua;GUO Donghua;LIU Zhifeng(Department of Radiology,Zengcheng District People's Hospital of Guangzhou,Guangzhou 511300,China;Department of Radiology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China)
出处
《中国医学影像技术》
CSCD
北大核心
2020年第8期1225-1229,共5页
Chinese Journal of Medical Imaging Technology
基金
广东省科技计划(2014A020212426)
广州市科技计划(201510010087)
广州市增城区人民医院临床研究培育项目(2019-LC-002)。
关键词
骨质疏松
脊柱骨折
椎体内裂隙
骨成形术
osteoporosis
spinal fractures
intravertebral cleft
osteoplasty
