椎体成形术后相邻椎体再骨折

Refractures of adjacent vertebral bodies after percutaneous vertebroplasty

近年来椎体成形术后相邻椎体再骨折的发生已引起临床医生的广泛关注。椎体成形术后相邻椎体再发骨折的可能原因有力学和临床两方面因素,前者主要是指相邻椎体刚度和强度的改变而后者主要是指骨水泥的外渗及相邻椎体自身骨质疏松的严重程度。是否采取预防措施防止相邻椎体发生骨折目前尚无定论,成为今后的研究方向:主要包括预防性应用椎体成形术和寻找理想骨水泥替代物。笔者对上述观点作一综述。

In recent years clinicians have paid more attention to refracture of the adjacent vertebral bodies after vertebroplasty. The possible causes of refracture after vertebroplasty include both mechanical and clinical factors, the former are the changes of strength and stiffness of the adjacent vertebral bodies and the latter are the extravasate of cement and the osteoporosis severity itself of the adjacent vertebral bodies. Whether preventive measures for refracture of adjacent vertebral bodies should be taken remains controversial. So future studies should be focused on both prophylactic stabilization of adjacent segments by kyphoplasty and searching for optimal bone cement substitute. The views of above-mentioned are reviewed in this article.