MRI对骨质疏松性椎体压缩骨折患者椎体终板和骨折椎体邻近间盘损伤的评估及其临床意义

Evaluation on vertebral endplate injury and adjacent intervertebral disk injury of patients with osteoporotic vertebral compression fractures by MRI and its clinical significance

目的:探讨通过MRI评价急性或亚急性骨质疏松性椎体压缩骨折(OVCF)患者椎体终板损伤和骨折椎体邻近间盘损伤的关系,为OVCF的诊断提供依据。方法:选择行椎体成型术的66例(76个骨折椎体)老年OVCF患者临床资料,通过MRI评估患者骨折椎体终板和骨折椎体邻近间盘的损伤情况。结果:76个骨折椎体中57个椎体有终板损伤(75%)。57个有终板损伤的骨折椎体中27个椎体只有上终板损伤(47%),22个椎体同时有上下终板损伤(39%),8个椎体只有下终板损伤(14%)。76个骨折椎体中48个椎体有邻近间盘损伤(63%)。48个有邻近间盘损伤的骨折椎体中22个间盘损伤位于骨折椎体上方(45%),19个骨折椎体同时有上下间盘损伤(40%),7个间盘损伤位于骨折椎体下方(15%)。结论:骨折椎体终板损伤与邻近椎间盘损伤有密切关联,提示临床诊断和治疗中应重视骨折椎体的终板损伤及邻近间盘损伤。

Objective To investigate the relationship between vertebral endplate injury and adjacent intervertebral disk injury of patients with acute or sub-acute osteoporotic vertebral compression fractures（OVC-F）by MRI,and to provide basis for diagnosis of OVCF.Methods The clinical data of a total of 66 patients with OVCF underwent vertebroplasty（76 fracture of vertebral bodies）were selected.The vertebral endplate injury and adjacent intervertebral disk injury of OVCF patients were detected by MRI.Results There were 57 vertebral endplate injury in 76 fracture vertebral bodies（75%）.There were only 27 vertebral bodies with vertebral endplate injury in 57 fractrue vertebral bodies with endplate injury（47%）,and 22 vertebral bodies with superior and inferior vertebral endplate injury（39%）,and 8 vertebral bodies with inferior vertebral endplate injury（14%）.There were 48 vertebral bodies with intervertebral disc injury in 76 fracture vertebral bodies（63%）.There were 22 intervertebral disc injury located above the fracture of the lumbar spine in 48 vertebral bodies with intervertebral disc injury（45%）,and 19 fracture vertebral bodies with upper and lower intervertebral disc injury（40%）,and 7 intervertebral injuries located below the fracture of the lumbar spine（15%）.Conclusion Vertebral endplate injury is frequently associated with the adjacent intervertebral disk injury.The clinical diagnosis and treatment should be emphasized in the fracture vertebral endplate damage and adjacent intervertebral disc injury.