MRI预测经皮椎体强化术骨水泥椎间盘渗漏的价值

发布时间：2018-01-15 18:42

  本文关键词：MRI预测经皮椎体强化术骨水泥椎间盘渗漏的价值　出处：《中国医学影像技术》2017年07期 　论文类型：期刊论文

  更多相关文章： 骨质疏松 脊柱骨折 经皮椎体成形术 磁共振成像

【摘要】：目的探讨术前MRI预测经皮椎体强化术(PVA)中骨水泥椎间盘渗漏的临床价值。方法回顾性分析经PVA治疗的127例骨质疏松性椎体压缩性骨折(OVCF)患者的临床及影像资料,比较患者年龄、性别、手术椎体部位、手术方式及术前MRI是否存在骨折椎体终板损伤、达终板骨折线、邻近椎间盘损伤及椎体裂隙时骨水泥椎间盘渗漏率的差异。结果 127例OVCF患者中,手术椎体179个,涉及358个终板及341个椎间盘。有终板损伤、达终板骨折线、邻近椎间盘损伤及椎体裂隙征象的骨水泥邻近椎间盘渗漏率分别为57.73%(56/97)、60.98%(25/41)、35.91%(51/142)、55.56%(20/36),均高于无上述征象椎体(P均0.05)。经皮椎体后凸成形术(PKP)及经皮椎体成形术(PVP)患者椎体骨水泥椎间盘渗漏率分别为26.67%(16/60)、42.86%(51/119),两者差异具有统计学意义(P=0.035)。骨水泥注入量≤5ml椎体骨水泥椎间盘渗漏率为31.19%(34/109),低于骨水泥注入量5ml椎体[47.14%(33/70),P=0.031)]。性别、年龄、手术椎体部位对邻近椎间盘骨水泥渗漏的影响无统计学意义(P0.05)。结论术前MRI能有效预测PVA术中骨水泥向邻近椎间盘渗漏,选择PKP及控制骨水泥注入量等方式可以降低骨水泥椎间盘渗漏的风险。
[Abstract]:Objective to evaluate the clinical value of preoperative MRI in predicting the leakage of bone cement disc in percutaneous vertebra augmentation. Methods 127 cases of osteoporotic vertebral compression fracture treated with PVA were retrospectively analyzed. Clinical and imaging data of patients with OVCFS. To compare the age, sex, site of operation vertebral body, operation method and MRI before operation whether there is fracture vertebral body endplate injury, to the end plate fracture line. Results among the 127 patients with OVCF, 179 were operated. Involving 358 endplates and 341 intervertebral discs. The osseous cement adjacent disc leakage rates of adjacent disc injuries and vertebral fissure signs were 57.73 / 97 / 60.98 / 25 / 41, respectively. 35.91 / 141 / 55.56 / 20 / 36). The rate of cement disc leakage in patients with percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) was 26.67, respectively (. 16 / 60. 42.86 / 51 / 119. The difference between the two groups was statistically significant (P < 0.035). The leakage rate of intervertebral disc with bone cement 鈮，

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