骨质疏松性椎体压缩骨折PVP/PKP术后术椎再塌陷危险因素的研究进展

Research progress of risk factors of vertebral recollapse after PVP/PKP for osteoporotic vertebral compression fracture

骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)是骨质疏松症最常见的并发症之一,经皮椎体成形术(percutaneousvertebroplasty,PVP)及经皮椎体后凸成形术(percutaneousky phoplast y,PKP)是治疗OVCF广泛应用的微创手术,手术椎体再次塌陷严重影响患者治疗效果及生活质量。PVP/PKP术后术椎再次塌陷时常发生,术椎存在椎体内裂隙样变(inter vertebralcleft,IVC)、骨折椎体位于胸腰椎交界区域、术椎更大的椎体后凸角、行PKP术、术中骨水泥呈团块状分布、过度前缘椎体高度恢复及术后未严格抗骨质疏松治疗是骨水泥椎体再塌陷的危险因素。应用PVP/PKP术治疗OVCF时应考虑上述再塌陷危险因素,以降低发生术椎再次塌陷的风险。

Osteoporotic vertebral compression fracture (OVCF) is one of the most common complication of osteoporosis. Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are the minimally invasive surgery widely used in the treatment of OVCF. Recollapse of the operative vertebral body seriously affects the treatment effect and quality of life of patients. Recollapse of cemented vertebrae occasionally occurs after PVP/PKP. Presence of intervertebral cleft in fractured vertebral, fracture at the thoracolumbar junction, the greater preoperative local kyphotic angle and performing PKP, filled with solid lump cement and significant anterior vertebral height restoration and no strict anti-osteoporosis treatment are risk factors of recollapse of cemented vertebrae after vertebral augmentation. The above-mentioned risk factors for recollapse should be taken into account when performing PVP/PKP for OVCF, as to reduce the risk of recollapse of cemented vertebrae.