经皮椎体成形术后再发骨折的临床研究

Clinical Study for New Vertebral Body Fracture After Percutaneous Vertebroplasty

目的观察经皮椎体成形术后患者再发椎体骨折的临床特点,探讨其发生机制、疗效及临床意义。方法回顾分析2004年2月～2009年3月行经皮椎体成形术共342例,其中经诊断并治疗的再发椎体骨折19例。结果再发椎体压缩性骨折率5.6%,平均年龄70.1岁,男女比例7∶12,相邻椎体再发率71.4%,非相邻椎体再发率28.6%,43%再发于术后60 d以内。再次手术后VAS评分显著降低,效果满意。结论椎体成形术后再发椎体骨折近2/3发生在邻近椎体,再次行椎体成形术可获得较为满意的临床效果。

Objective To investigate the clinical feature of new vertebral body compression fractures afer percutaneous vertebroplasty,including the pathogenesis and curative effect.Methods From February 2004 to March 2009 in our hospital,342 patients were treated with percutaneous vertebroplasty.A retrospective study showed that new vertebral body compression fractures were found in 19 cases,and all of these cases were retreated with percutaneous vertebroplasty.Results Of 342 patients treated with percutaneous vertebroplasty,5.6% developed a t otal of 35 new vertebral body fractures.Of the 35 newly documented fractures,average age was 70.1 years old,M-F was 7：12,71.4% involved vertebrae adjacent to the previously treated vertebral level,43% of the new fracture occurred within 60 days after treatment of the initial treatment.All of the new fractured vertebral body were retreated with percutaneous vertebroplasty.Conclusion Two-thirds of the re-fractures occur in adjacent vertebral bodies and can be treated with percutaneous vertebroplasty again with satisfied results.