椎体骨折影像类型与椎体成形术疗效关系探讨

Discussing relation both Image types for vertebral body fractures and curative effect of Percutaneous Verebroplasty

目的:为探讨椎体骨折影像类型与椎体成形术疗效的关系。方法:采用椎体成形术治疗骨质疏松性胸腰椎骨折348例。按椎体骨折影像学形态改变将骨折病例分为5种类型:Ⅰ型:无变形型32例;Ⅱ型:单纯压缩型75例;Ⅲ型:非后缘崩裂型139例;Ⅳ型:后缘崩裂形65例;Ⅴ型:椎管轻度占位型37例。将五种型椎体骨折病例椎体成形术疗效进行比较分析。结果:随访6～12个月,5种类型中术后疗效以Ⅰ型疗效最佳,完全缓解(CR)率100%。Ⅱ型CR率94.67%,Ⅲ型CR率88.49%,Ⅳ型CR率86.15%,Ⅴ型CR率86.49%。疗效对比结果:除Ⅱ型与Ⅰ型之间对比结果差异无显著性外,其他类型与Ⅰ型对比结果差异均有显著性。结论:胸腰椎骨折影像诊断类型与椎体成形术疗效、风险直接相关,有重要临床意义。

Objective：To explore relation between Image type for vertebral body fractures and curative effects of Percutaneous Verebroplasty （PVP）. Methods： 348 patients with osteoporotic vertebral body fractures in thoracic vertebral or lumbar vertebral were treated by PVP. Before the operation, According to their shapes on Image, vertebral body fracture were divide to 5 types, model Ⅰ , no shape change type 32 cases ; Model Ⅱ , simple compressed type 75 cases; model Ⅲ, crack not at back fringe type 139 cases; model Ⅳ, crack at back fringe type 65 cases ; model Ⅴ , osseous debris intrude canalis vertebralis type 37 cases. Comparison curative effects and cement leak rate between model I with other one model. Results ： Follow - up 6 - 12 months, find to that model Ⅰ curative effect was best. 32 cases the symptoms complete remission （CR） at all,the CR rate was 100%. Model Ⅱ 75 cases,the CR rate was 94.67%. model Ⅲ 139 cases,the CR rate was 88.49%. model Ⅳ 65 cases, the CR rate was 86. 14%. model Ⅴ 37 ases, the CR rate was 86. 49%. Curative effect contrast results： Cement leak out vertebral body contrast results were same with Curative effect contrast. Conclusions：Image types for vertebral body fractures with curative effect and risks of PVP there are direct relation, there are important significance at clinic.