经皮椎体强化术后液体信号征与邻近椎体骨折相关性分析

Correlative Analysis of Fluid Sign and Adjacent Vertebral Fracture After Percutaneous Vertebral Augmentation

目的探讨经皮椎体强化术(PVA)后MRI手术椎体内液体信号征与邻近椎体骨折(AVF)相关性。方法回顾性研究经PVA治疗的105例骨质疏松性椎体压缩性骨折(OVCF)患者的临床及MRI资料,分析术前、术后MRI手术椎体内是否存在液体信号征及与AVF发生率的关系,并比较不同年龄、性别、手术方式、骨水泥注入量间AVF发生率的差异。结果 105例OVCF患者中,手术椎体共200个。术前MRI手术椎体内液体信号征发生率为15%(30/200),AVF发生率为53.3%(16/30),明显高于术前无液体信号征组(P<0.05);术后MRI手术椎体内液体信号征发生率为27.5%(55/200),AVF发生率为54.5%(30/55),明显高于术后无液体信号征组(P<0.05)。手术椎体术后液体信号征有吸收与无吸收AVF发生率分别为53.9%(9/17)、50%(5/10),两组比较差异无统计学意义(P=0.883)。骨水泥注入量≤5 ml组AVF发生率29.4%(42/143),明显低于骨水泥注入量> 5 ml组(50.9%,29/57)(P<0.05)。年龄、性别及手术方式对AVF的影响无统计学意义。结论术前或术后MRI手术椎体内液体信号征是术后AVF的危险因素,严格控制骨水泥注入量,对减少术后AVF发生率具有帮助。

Objective To investigate the correlation between fluid signals in the vertebral body and the adjacent vertebral fracture(AVF) after MRI in percutaneous vertebroplasty(PVA). Methods The clinical and MRI data of 105 patients with osteoporotic vertebral compression fracture(OVCF) treated with PVA were retrospectively analyzed. The presence of fluid signals and AVF in the vertebral body before and after MRI were analyzed. Relationships, and the differences in the incidence of AVF between different ages, genders, surgical procedures, and bone cement injections were compared. Results Of the 105 patients with OVCF, there were 200 surgical vertebral bodies. The incidence of fluid signal in the vertebral body before operation was 15%(30/200), and the incidence of AVF was 53.3%(16/30), which was significantly higher than that in the preoperative fluid-free group(P<0.05). The incidence of fluid signal in the vertebral body of MRI was 27.5%(55/200), and the incidence of AVF was 54.5%(30/55), which was significantly higher than that in the no-fluid group(P<0.05). The incidence of fluid recruitment and non-absorbed AVF after surgical vertebral body surgery were 53.9%(9/17) and 50%(5/10), respectively. There was no significant difference between the two groups(P=0.883). The incidence of AVF in the amount of bone cement injection ≤ 5 ml was 29.4%(42/143), which was significantly lower than that of bone cement injection > 5 ml group(50.9%, 29/57)(P<0.05). The effects of age, gender, and surgical procedure on AVF were not statistically significant. Conclusion The preoperative or postoperative MRI vertebral fluid signal is a risk factor for postoperative AVF. Strict control of bone cement injection is helpful to reduce the incidence of postoperative AVF.