椎体成形术后相邻椎体骨折病因与预防策略的研究进展

Latest advances of the cause and preventive strategies of adjacent vertebral body fracture after percutaneous vertebroplasty

椎体成形术是治疗椎体压缩性骨折的有效方法,但越来越多的文献报道术后其相邻椎体出现了新发骨折,并已引起临床医生的广泛关注,但两者之间究竟是否存在因果关系,目前尚无定论。椎体成形术后相邻椎体骨折的可能原因有椎体机械力学、椎体填充剂及临床等因素,主要与相邻椎体刚度和强度的改变、骨水泥的外渗、椎体自身骨质疏松等因素相关。本文针对上述原因,从相邻椎体预防性应用骨水泥、同一骨折椎体再次PVP治疗及开发新型填充剂等方面探讨其预防的策略并对此作一综述。

Percutaneous vertebroplasty（PVP） is widely used as an effective treatment for compression fracture,additional adjacent vertebral body fractures are frequently reported after operation,but the relationship between the vertebroplasty and adjacent vertebral body fracture remains unknown. The possible causes of refracture after operation include mechanical force factor,bone cement and clinical factors. Except for the changes of stress and stiffness of the adjacent vertebral bodies,the extravasation of cement and osteoporosis itself of the vertebral bodies should be concerned about. To aim at above mentioned reasons,simultaneously,preventive strategies,such as prophylactic cement injection into adjacent non fractured vertebrae,additional PVP and injectable copolymer hydrogel are approached in this review.