骨质疏松性椎体压缩骨折骨水泥强化术后邻近椎体骨折相关因素研究进展

Research Progress in Related Factors of Adjacent Vertebral Fracture after Bone Cement Augmentation for Osteoporotic Vertebral Compression Fracture

骨水泥强化术包括经皮椎体成形术和经皮椎体后凸成形术,现已广泛应用于治疗骨质疏松性椎体压缩骨折并取得显著效果。近年来,随着手术病例的增多,骨水泥强化术后邻近椎体骨折的发生率明显增加。术后邻近椎体骨折与术中骨水泥注入量的多少、骨水泥椎间盘渗漏、椎体高度的过度恢复等手术因素及骨质疏松的自然进程、初始骨折的位置数目、椎体内裂隙样变、其他部位骨折史等非手术因素密切相关。因此,未来在使用骨水泥强化术治疗椎体压缩骨折时,应合理注入骨水泥量、避免骨水泥椎间盘渗漏和椎体高度过度恢复,规范手术流程,以减少术后邻近椎体骨折的发生。

Bone cement augmentation,including percutaneous vertebroplasty and percutaneous kyphoplasty,has been widely used in the treatment of osteoporotic vertebral compression fractures and achieved significant results.In recent years,with the increase of surgical cases,the incidence of fractures of adjacent vertebral bodies after augmentation surgery has increased significantly.Postoperative adjacent vertebral body fractures are closely related to operative factors such as the amount of cement injected,intervertebral leakage of cement,excessive recovery of vertebral height,and non-operative factors such as the natural course of osteoporosis,the position and number of initial fractures,the fissure-like changes in vertebral body and the history of fracture in other parts.Therefore,in the future,in the treatment of vertebral compression fractures with bone cement reinforcement,the amount of bone cement should be injected reasonably,the intervertebral leakage of bone cement and the excessive recovery of vertebral height should be avoided,and the operation procedure should be standardized,so as to reduce the occurrence of adjacent vertebral fracture after operation.