三明治椎体骨水泥强化术后夹心椎再骨折危险因素的研究进展

Research Progress on Risk Factors of Sandwich Vertebrae Refracture after Sandwich Bone Cement Augmentation

背景:随着全球人口老龄化日渐严重,骨质疏松性椎体骨折的发生日益增多,三明治椎体骨折作为一种上下椎体压缩骨折而中间椎体完好的特殊类型椎体骨折,相关研究报道其夹心椎体再骨折的发生率明显高于其它椎体。为降低夹心椎体较高的再骨折率,国内外学者对骨水泥强化术后夹心椎体再骨折的危险因素进行了广泛深入的研究,但目前依然存在许多不确定性和争议性。目的:总结既往研究,综述夹心椎体再骨折危险因素的研究进展,并展望其预防和改进方向。方法:检索各个数据库中关于三明治椎体夹心椎再骨折危险因素的相关文献,选取具有价值的实验研究和临床病例。结果与结论:1) 通过对当前关于三明治椎体夹心椎再骨折的相关研究总结分析,发现其危险因素包括生物力学改变、骨质疏松、高龄、椎间隙骨水泥渗漏及其他因素等;2) 通过避免上述危险因素,希望能为临床降低夹心椎体再骨折率提供一定帮助,并相信以后随着技术的不断改进,尽可能减少病人二次骨折的痛苦。

Background: With the aging of the global population, the occurrence of osteoporotic vertebral frac-tures is increasing. Sandwich vertebral fracture is a special type of vertebral fracture with the up-per and lower vertebral compression fracture and the middle vertebral body intact. Relevant stud-ies have reported that the incidence of sandwich vertebral refracture is significantly higher than that of other vertebral bodies. In order to reduce the high refracture rate of sandwich vertebrae, scholars at home and abroad have conducted extensive and in-depth studies on the risk factors of refracture of sandwich vertebrae after bone cement augmentation, but there are still many uncer-tainties and controversies. Objective: To summarize the previous studies, review the research pro-gress on the risk factors of sandwich vertebral refracture, and look forward to its prevention and improvement. Methods: The relevant literatures on the risk factors of sandwich vertebral refrac-ture were searched in various databases, and the valuable experimental studies and clinical cases were selected. Results & Conclusions: 1) The risk factors of sandwich vertebral refracture include biomechanical changes, osteoporosis, advanced age, intervertebral cement leakage and other fac-tors. 2) By avoiding the above risk factors, we hope to provide some help for reducing the re-fracture rate of sandwich vertebrae in clinical practice, and believe that with the continuous im-provement of technology in the future, the pain of second fracture of patients will be reduced as much as possible.