椎体内裂隙及其位置对骨质疏松椎体压缩骨折疗效影响

发布时间：2018-09-04 16:31

【摘要】：[目的]分析骨质疏松椎体压缩骨折(osteoporotic vertebral compression fractures,OVCFs)中椎体内裂隙(intravertebral vacuum cleft,IVC)发病率及其在伤椎内位置特点,并比较不同位置IVC对经皮椎体强化术治疗有IVC的OVCFs治疗效果影响差异。[方法]共有52例单节段并位于胸腰区域(T_(11)~L_1)有IVC的OVCFs患者纳入回顾性研究,随访时间均超过两年。根据IVC在伤椎内的位置特点,将所有患者分为三组:IVC偏上组、IVC偏下组和IVC达到上下终板组。三组组间及组内相应的放射学和临床参数在术前、术后(即时、术后1年、术后2年)分别比较。[结果]三组患者术前基值差异均无统计学意义,具有可比性。三组患者术后即时的椎体高度及后凸角均显著矫正;三组术后即时放射学及临床参数差异无统计学意义。在术后1、2年随访期间内,三组患者椎体高度及后凸角角均进展性加重,尤以IVC偏下组为最重,其次是IVC偏上组。三组在伤椎复位率及复位角差异无统计学意义(P0.05);IVC偏下组2年内的高度及后凸丢失率显著超过其他两组(P0.05)。[结论]经皮椎体强化术起初对于所有IVC的OVCFs患者有效。然而,在后期随访中IVC偏下组更易出现严重的椎体再塌陷及后凸畸形,因此建议术后需要严密的观察及随访。
[Abstract]:[objective] to analyze the incidence of intravertebral fissure (intravertebral vacuum cleft,IVC) in osteoporotic vertebral compression fracture (osteoporotic vertebral compression fractures,OVCFs) and its location in injured vertebrae, and to compare the effect of IVC in different locations on the effect of OVCFs in the treatment of percutaneous vertebra compression fracture (IVC). [methods] A total of 52 patients with IVC in the thoracolumbar region (T _ (11) L _ L _ 1) were included in the retrospective study. The follow-up time was more than two years. According to the location of IVC in the injured vertebrae, all the patients were divided into three groups: the upper group and the lower group and the group of IVC reaching the upper and lower endplate. The radiologic and clinical parameters of the three groups were compared before and after operation (immediate, 1 year, 2 years after operation). [results] there was no significant difference in preoperative baseline values among the three groups. The vertebral height and kyphosis angle were corrected significantly in the three groups, but there was no significant difference in radiology and clinical parameters. During the 1- and 2-year follow-up period, the vertebral body height and kyphoid angle of the three groups were increased, especially in the lower group of IVC, followed by the upper group of IVC. There was no significant difference in reduction rate and reduction angle between the three groups (P0.05). The height and the loss rate of kyphosis in IVC group were significantly higher than those in the other two groups (P0.05). [conclusion] Percutaneous vertebra enhancement was initially effective in all IVC patients with OVCFs. However, severe vertebral recollapse and kyphosis are more likely to occur in the lower IVC group during late follow-up, so it is recommended to observe and follow up closely after the operation.
【作者单位】：广州中医药大学第一附属医院脊柱骨科;广州中医药大学第一临床医学院;
【基金】：广东省卫生厅医学科研基金项目(编号:2014B2014175) 卫生部医药卫生科技发展研究中心资助课题(编号:W2014ZT256;W2012ZT0)
【分类号】：R580;R687.3

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