MRI成像分析OVCF患者经PVP术后影像学特征研究

Analysis of imaging features of OVCF patients by MRI imaging after PVP surgery

目的探讨影像学检查对骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)病人经皮椎体成形术(percutaneous vertebro plasty,PVP)后影像学特征及伤椎再次骨折的预估价值。方法选择2019年7月—2023年6月本院收治的OVCF行PVP术后治疗的180例患者作为研究对象,根据骨折情况分为伤椎再次骨折组(21例)和无再次骨折组(159例)两组。对比分析两组患者的性别、年龄、骨折线有无累及至椎体终板、术前有无椎体裂隙、术后骨水泥周围有无积液、骨水泥是否与伤椎上下终板相接触、骨水泥用量、有无骨水泥泄漏等临床资料及影像学特征,对差异有统计学意义(P<0.05)的指标进行分析,探讨影像学检查对预估伤椎再次骨折的诊断价值,分析伤椎再次骨折的危险因素。结果180例患者PVP术后,伤椎再发骨折21例,无再次骨折159例,伤椎再骨折发生率为11.7%。两组骨折线有无累及至椎体终板、术前有无椎体裂隙、骨水泥是否与伤椎上下终板未接触、术后骨水泥周围有无积液等资料比较,差异均有统计学意义(P<0.05)。两组的性别、年龄、骨水泥用量、有无骨水泥泄漏比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,骨折线有无累及至椎体终板、术前有无椎体裂隙、术后骨水泥周围有无积液是伤椎再骨折发生的危险因素。结论通过MRI成像分析OVCF病人经PVP术后伤椎影像学特征对预估伤椎再次骨折有潜在的应用价值,为临床降低患者伤椎再次骨折发生率、改善预后提供参考依据。

Objective To explore the value of imaging examination on imaging characteristics of patients underwent percutaneous vertebro plasty(PVP)due to osteoporotic vertebral compression fractures(OVCF)and its value in predicting re-fracture of injured vertebra.Methods 180 patients suffering from OVCF who underwent treatment of PVP in our hospital from July 2019 to June 2023 were enrolled as study subjects,and they were divided into a group with recurrent vertebral fractures(21 patients)and a group without recurrent fractures(159 patients)according to fracture status.The clinical data and imaging characteristics of two groups of patients,including gender,age,whether the fracture line affected the vertebral endplate,whether there were vertebral fissures before surgery,whether there was fluid accumulation around the bone cement after surgery,whether the bone cement contacted the upper and lower endplates of the injured vertebra,the amount of bone cement used,and whether there was bone cement leakage were compared and analyzed between the two groups.The indicators with statistical significance were analyzed.To explore the diagnostic value of imaging examination in predicting the re-fracture of the injured vertebra,and analyze the risk factors for re-fracture of the injured vertebra.Results Among the 180 patients who underwent PVP surgery,there were 21 cases of recurrent vertebral fractures and 159 cases of no recurrent fractures.The incidence of recurrent vertebral fractures was 11.7%.There were statistically significant differences between the two groups in terms of whether the fracture line affected the vertebral endplate,whether there were vertebral fractures before surgery,whether the bone cement did not come into contact with the upper and lower endplates of the injured vertebra,and whether there was fluid accumulation around the bone cement after surgery(P<0.05).There were no statistically significant difference in gender,age,amount of bone cement used,and the presence or absence of bone cement leakage between the two groups(P>0.05).The results of multivariate logistic regression analysis showed that the presence or absence of vertebral endplate involvement,preoperative vertebral fractures,and postoperative fluid accumulation around bone cement were risk factors for recurrent vertebral fractures.Conclusions Analyzing the imaging characteristics of the injured vertebrae in OVCF patients after PVP surgery through MRI imaging has potential application value in predicting the recurrence of injured vertebrae fractures,providing reference basis for reducing the incidence of injured vertebrae re-fractures and improving prognosis in clinical practice.