摘要
背景:经皮椎体成形术是治疗骨质疏松性椎体压缩骨折应用最广泛的方法,多数研究认为经皮椎体成形术会增加继发性邻近椎体压缩骨折的概率。然而,对于经皮椎体成形术后引起的邻椎再骨折相关危险因素仍然存在争议。目的:归纳并总结骨质疏松性椎体压缩骨折患者行经皮椎体成形术后邻近椎体再发骨折的影响因素,为降低其发生风险以及制定相应治疗方案提供一定的参考。方法:以“骨质疏松症,骨折,经皮椎体成形术,邻近椎体压缩骨折,危险因素”为中文检索词,以“osteoporosis,osteoporotic vertebral compression fractures,percutaneous vertebroplasty,adjacent vertebral compression fractures,risk factors”为英文检索词,应用计算机检索中国知网、万方医学网、维普、PubMed、Springer、ScienceDirect及Elsevier数据库收录的相关文献。检索时限重点为2018年1月至2023年9月,同时纳入少数经典远期文献。通过阅读文题和摘要进行筛选,最终纳入83篇文献进行综述。结果与结论:(1)骨质疏松性椎体压缩骨折是骨质疏松症最常见的并发症之一,使老年患者致残和死亡的风险显著增加。经皮椎体成形术是治疗骨质疏松性椎体压缩骨折切实有效的方法。(2)随着经皮椎体成形术的普及,继发椎体压缩性骨折也逐渐增多,以邻近椎体压缩骨折最为常见。(3)以往的研究仅讨论了骨密度、多发椎体骨折、身体质量指数、年龄、性别、骨水泥的用量、骨水泥渗漏及抗骨质疏松治疗等因素对经皮椎体成形术后继发邻近椎体压缩骨折的影响,而对于椎体骨折数量、手术时机、手术方式、骨水泥材料、骨水泥弥散分布、伤椎恢复高度和术后佩戴支具等方面总结的尚不全面,并且对危险因素引起邻椎骨折的具体机制分析也较为少见。(4)文章结果表明,骨密度过低、高龄、围绝经期女性、多发椎体骨折、伤椎高度的过度�
s,and 83 papers were finally included in the review.RESULTS AND CONCLUSION:(1)Osteoporotic vertebral compression fractures are one of the most common complications of osteoporosis,placing elderly patients at a significant risk of disability and death.Percutaneous vertebroplasty is a practical and effective treatment for osteoporotic vertebral compression fractures.(2)With the popularity of percutaneous vertebroplasty,its secondary vertebral compression fractures have gradually increased,with adjacent vertebral compression fractures being the most common.(3)Previous studies have only discussed the effects of factors such as bone mineral density,multiple vertebral fractures,body mass index,age,sex,amount of bone cement,cement leakage,and anti-osteoporosis treatment on secondary compression fractures of adjacent vertebrae after percutaneous vertebroplasty,and summarized the number of vertebral fractures,timing of the operation,surgical approach,cement material,diffuse distribution of bone cement,recovery height of the injured vertebrae,and wearing of a support after surgery,which is not yet comprehensive.The analysis of the specific mechanisms of risk factor-induced adjacent vertebral fractures is relatively rare.(4)The results of the article showed that low bone mineral density,advanced age,perimenopausal women,multiple vertebral fractures,excessive recovery of the height of the injured vertebrae,cement leakage,comorbid underlying diseases,and poor lifestyle habits were the risk factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty,and that maintaining a normal body mass index,early surgery,bilateral percutaneous vertebroplasty,use of a new type of cement material,an appropriate volume of bone cement injection and uniform cement dispersion,regular anti-osteoporosis treatment,and postoperative brace wearing are protective factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty.
作者
柳栋元
关海山
史浩冉
刘晓亮
周浩盛
Liu Dongyuan;Guan Haishan;Shi Haoran;Liu Xiaoliang;Zhou Haosheng(Department of Orthopedics,Second Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2024年第36期5884-5891,共8页
Chinese Journal of Tissue Engineering Research
关键词
骨质疏松症
骨折
经皮椎体成形术
邻近椎体压缩性骨折
危险因素
骨密度
骨水泥
高龄
女性
抗骨质疏松治疗
osteoporosis
fractures
percutaneous vertebroplasty
adjacent vertebral compression fractures
risk factor
bone mineral density
bone cement
advanced age
woman
anti-osteoporosis treatment
