目的探讨骨水泥弥散类型与PVP术后早期镇痛效果及延迟性椎体高度丢失的相关性。方法对本科2016年1月-2018年10月采用PVP手术治疗的81例OVCF患者进行观察,依据术后骨水泥弥散等级分为三组:骨水泥弥散等级为1级26例,纳入1组;2级36例,纳入2...目的探讨骨水泥弥散类型与PVP术后早期镇痛效果及延迟性椎体高度丢失的相关性。方法对本科2016年1月-2018年10月采用PVP手术治疗的81例OVCF患者进行观察,依据术后骨水泥弥散等级分为三组:骨水泥弥散等级为1级26例,纳入1组;2级36例,纳入2组;3级19例,纳入3组。对三组患者的术后3 d、术后1年VAS评分及延迟性高度丢失情况进行比较;同时,对骨水泥弥散等级与VAS评分、延迟性高度丢失值进行Spearman相关性分析。结果术后3 d,三组VAS评分均较术前显著降低(P<0.05),但1组>2组>3组,差异有统计学意义(P<0.05);三组术后1年的VAS评分差异无统计学意义(P>0.05)。术后1年,三组患者均出现伤椎高度丢失现象,但1组>2组>3组,差异有统计学意义(P<0.05)。经Spearman相关性分析,骨水泥弥散等级与术后3 d VAS评分、椎体延迟性高度丢失值呈负相关关系(P<0.05)。结论骨水泥弥散等级越高,则PVP术后的即时镇痛效果越好、椎体高度丢失也越轻微。展开更多
BACKGROUND Osteoporotic vertebral compression fractures(OVCFs)contribute to back pain and functional limitations in older individuals,with percutaneous vertebroplasty(PVP)emerging as a minimally invasive treatment.How...BACKGROUND Osteoporotic vertebral compression fractures(OVCFs)contribute to back pain and functional limitations in older individuals,with percutaneous vertebroplasty(PVP)emerging as a minimally invasive treatment.However,further height loss post-PVP prompts investigation into contributing factors.AIM To investigate the factors associated with further height loss following PVP with cement augmentation in OVCF patients.METHODS A total of 200 OVCF patients who underwent successful PVP between January 2021 and December 2022 were included in this study.“Further height loss”during 1 year of follow-up in OVCF patients with bone edema was defined as a vertical height loss of≥4 mm.The study population was divided into two groups for analysis:The“No Further Height Loss group(n=179)”and the“Further Height Loss group(n=21).”RESULTS In comparing two distinct groups of patients,significant differences existed in bone mineral density(BMD),vertebral compression degree,prevalence of intravertebral cleft(IVF),type of bone cement used,and cement distribution patterns.Results from binary univariate regression analysis revealed that lower BMD,the presence of IVF,cleft distribution of bone cement,and higher vertebral compression degree were all significantly associated with further height loss.Notably,the use of mineralized collagen modified-poly(methyl methacrylate)bone cement was associated with a significant reduction in the risk of further height loss.In multivariate regression analysis,lower BMD and the presence of IVF remained significantly associated with further height loss.CONCLUSION Further height loss following PVP in OVCF patients is influenced by a complex interplay of factors,especially lower BMD and the presence of IVF.These findings underscore the importance of assessing and managing these factors when addressing height loss following PVP in OVCF patients.展开更多
This retrospective study investigated the impact of endplate fracture on postoperative vertebral height loss and kyphotic deformity in 144 patients with osteoporotic vertebral compression fracture （OVCF）, who receiv...This retrospective study investigated the impact of endplate fracture on postoperative vertebral height loss and kyphotic deformity in 144 patients with osteoporotic vertebral compression fracture （OVCF）, who received balloon kyphoplasty. Patients were divided into four groups： Group 1 had no superior endplate fracture, Group 2 had fractures on the anterior portion of the superior endplate, Group 3 had fractures on the posterior portion of the superior endplate, and Group 4 had complete superior endplate fractures. Anterior and middle vertebral body height, vertebral compression ratio, vertebral height loss rate, and kyphosis Cobb angle of each patient were measured and visual analogue scale （VAS） and Oswestry disability index （ODI） scores were recorded. The anterior vertebral height and kyphosis deformity of all groups significantly improved after the surgery, whereas substantial anterior vertebral height loss and increased Cobb angle were observed in all patients at the last follow-up. Although the vertebral height loss rate and the Cobb angle in Group 2, 3 and 4 were larger compared with Group 1 at the last follow-up, only the vertebral height loss rate in Group 4 and the increase in the Cobb angle in Group 2 and 4 were statistically different from those in Group 1. The VAS and ODI scores in all groups measured after the surgery and at the last follow-up were significantly lower compared with preoperative scores, but there was no significant difference among these groups. Balloon kyphoplasty significantly improved vertebral fracture height and kyphosis. Vertebral height loss and increased kyphotic deformity were observed in OVCF patients with endplate fractures after the surgery. Postoperative aggravation of kyphosis was observed in Group 2. Furthermore, severe vertebral height loss and increased kyphotic deformity were confirmed in Group 4 after the surgery. Our results suggested that postoperative vertebral height loss and aggravation of kyphosis may be associated with biomechanical changes in 展开更多
文摘目的探讨骨水泥弥散类型与PVP术后早期镇痛效果及延迟性椎体高度丢失的相关性。方法对本科2016年1月-2018年10月采用PVP手术治疗的81例OVCF患者进行观察,依据术后骨水泥弥散等级分为三组:骨水泥弥散等级为1级26例,纳入1组;2级36例,纳入2组;3级19例,纳入3组。对三组患者的术后3 d、术后1年VAS评分及延迟性高度丢失情况进行比较;同时,对骨水泥弥散等级与VAS评分、延迟性高度丢失值进行Spearman相关性分析。结果术后3 d,三组VAS评分均较术前显著降低(P<0.05),但1组>2组>3组,差异有统计学意义(P<0.05);三组术后1年的VAS评分差异无统计学意义(P>0.05)。术后1年,三组患者均出现伤椎高度丢失现象,但1组>2组>3组,差异有统计学意义(P<0.05)。经Spearman相关性分析,骨水泥弥散等级与术后3 d VAS评分、椎体延迟性高度丢失值呈负相关关系(P<0.05)。结论骨水泥弥散等级越高,则PVP术后的即时镇痛效果越好、椎体高度丢失也越轻微。
基金the 2022 Panzhihua City Science and Technology Guidance Plan Project,No.2022ZD-S-35.
文摘BACKGROUND Osteoporotic vertebral compression fractures(OVCFs)contribute to back pain and functional limitations in older individuals,with percutaneous vertebroplasty(PVP)emerging as a minimally invasive treatment.However,further height loss post-PVP prompts investigation into contributing factors.AIM To investigate the factors associated with further height loss following PVP with cement augmentation in OVCF patients.METHODS A total of 200 OVCF patients who underwent successful PVP between January 2021 and December 2022 were included in this study.“Further height loss”during 1 year of follow-up in OVCF patients with bone edema was defined as a vertical height loss of≥4 mm.The study population was divided into two groups for analysis:The“No Further Height Loss group(n=179)”and the“Further Height Loss group(n=21).”RESULTS In comparing two distinct groups of patients,significant differences existed in bone mineral density(BMD),vertebral compression degree,prevalence of intravertebral cleft(IVF),type of bone cement used,and cement distribution patterns.Results from binary univariate regression analysis revealed that lower BMD,the presence of IVF,cleft distribution of bone cement,and higher vertebral compression degree were all significantly associated with further height loss.Notably,the use of mineralized collagen modified-poly(methyl methacrylate)bone cement was associated with a significant reduction in the risk of further height loss.In multivariate regression analysis,lower BMD and the presence of IVF remained significantly associated with further height loss.CONCLUSION Further height loss following PVP in OVCF patients is influenced by a complex interplay of factors,especially lower BMD and the presence of IVF.These findings underscore the importance of assessing and managing these factors when addressing height loss following PVP in OVCF patients.
基金supported by National Natural and Science Foundation(81271988)Jiangsu Natural and Science Foundation (BK2012876)
文摘This retrospective study investigated the impact of endplate fracture on postoperative vertebral height loss and kyphotic deformity in 144 patients with osteoporotic vertebral compression fracture （OVCF）, who received balloon kyphoplasty. Patients were divided into four groups： Group 1 had no superior endplate fracture, Group 2 had fractures on the anterior portion of the superior endplate, Group 3 had fractures on the posterior portion of the superior endplate, and Group 4 had complete superior endplate fractures. Anterior and middle vertebral body height, vertebral compression ratio, vertebral height loss rate, and kyphosis Cobb angle of each patient were measured and visual analogue scale （VAS） and Oswestry disability index （ODI） scores were recorded. The anterior vertebral height and kyphosis deformity of all groups significantly improved after the surgery, whereas substantial anterior vertebral height loss and increased Cobb angle were observed in all patients at the last follow-up. Although the vertebral height loss rate and the Cobb angle in Group 2, 3 and 4 were larger compared with Group 1 at the last follow-up, only the vertebral height loss rate in Group 4 and the increase in the Cobb angle in Group 2 and 4 were statistically different from those in Group 1. The VAS and ODI scores in all groups measured after the surgery and at the last follow-up were significantly lower compared with preoperative scores, but there was no significant difference among these groups. Balloon kyphoplasty significantly improved vertebral fracture height and kyphosis. Vertebral height loss and increased kyphotic deformity were observed in OVCF patients with endplate fractures after the surgery. Postoperative aggravation of kyphosis was observed in Group 2. Furthermore, severe vertebral height loss and increased kyphotic deformity were confirmed in Group 4 after the surgery. Our results suggested that postoperative vertebral height loss and aggravation of kyphosis may be associated with biomechanical changes in
