骨水泥椎间渗漏与椎体成形术术后再发椎体压缩骨折相关性研究

Impact of intervertebral cement leakage on development of subsequent vertebral compression fractures after percutaneous vertebroplasty

目的评估骨水泥椎间渗漏与椎体成形术(percutaneous vertebroplasty,PVP)术后再发椎体压缩骨折风险的相关性。方法对2009年6月～2011年6月行PVP手术治疗的153例骨质疏松性椎体压缩骨折患者进行回顾性研究,根据椎体再发骨折情况分为再发骨折组与对照组,记录2组患者骨密度、骨水泥注射量与骨水泥椎间隙渗漏情况。结果共124例患者(148个椎体)获得完整随访,平均随访18个月;24例患者(32个椎体)再发椎体压缩骨折。再发椎体压缩骨折患者骨水泥椎间渗透率为25.0%(6/24)与对照组的21.0%(21/100)差异无统计学意义(P>0.05)。再发椎体压缩骨折患者骨密度低于对照组,差异有统计学意义(P<0.05)。结论骨水泥椎间渗漏并不增加PVP术后再发椎体压缩骨折风险,低骨密度是再发椎体骨折的危险因素。

Objective To evaluate the association between intervertebral cement leakage and subsequent vertebral fractures after treatment of osteoporotic vertebral compression fractures by percutaneous vertebroplasty （PVP）. Methods From June 2009 to June 2011, 154 patients with osteoporotic vertebral compression fractures underwent PVP sessions, and 124 patients （ 148 levels） whose clinical data were complete were retrospectively enrolled in this study. The patients were divided into 2 groups according to whether the subsequent fractures eecured. The effect of intervertebral cement leakage on new vertebral fracture formation after PVP was evalu- ated. The mean bone mineral density （BMD, T score） and the injected cement volume were recorded. Resdts All 124 patients （ 148 levels） were followed up for mean 18 months. During the follow-up periods, subsequent vertebral fractures developed in 24 （ 19.3% ） of 124 patients. The incidence of intervertebral cement leakage was 25.0% （6/24） in the subsequent fracture group and 21.0% （21/100） in the control group respeetively（P 〉0. 05）. The BMD was significantly lower in the subsequent fracture group than in the control group. Conclusion Intervertebral cement leakage does not seem to be related to subsequent vertebral compression fracture in patients treated by PVP for osteoporotic compression fractures. The lower BMD is the risk factor for subsequent fracture.