BACKGROUND As one of the most common complications of osteoporosis,osteoporotic vertebral compression fracture(OVCF)increases the risk of disability and mortality in elderly patients.Percutaneous vertebroplasty(PVP)is...BACKGROUND As one of the most common complications of osteoporosis,osteoporotic vertebral compression fracture(OVCF)increases the risk of disability and mortality in elderly patients.Percutaneous vertebroplasty(PVP)is considered to be an effective,safe,and minimally invasive treatment for OVCFs.The recollapse of cemented vertebrae is one of the serious complications of PVP.However,the risk factors associated with recollapse after PVP remain controversial.AIM To identify risk factors for the recollapse of cemented vertebrae after PVP in patients with OVCFs.METHODS A systematic search in EMBASE,MEDLINE,the Cochrane Library,and PubMed was conducted for relevant studies from inception until March 2020.Studies investigating risk factors for the recollapse of cemented vertebrae after PVP without additional trauma were selected for analysis.Odds ratios(ORs)or standardized mean differences with 95%confidence interval(CI)were calculated and heterogeneity was assessed by both the chi-squared test and the I-squared test.The methodological quality of the included studies was assessed according to the Newcastle-Ottawa Scale.RESULTS A total of nine case-control studies were included in our meta-analysis comprising 300 cases and 2674 controls.The significant risk factors for the recollapse of cemented vertebrae after PVP in OVCF patients were fractures located at the thoracolumbar junction(OR=2.09;95%CI:1.30 to 3.38;P=0.002),preoperative intravertebral cleft(OR=2.97;95%CI:1.93 to 4.57;P<0.00001),and solid lump distribution pattern of the cement (OR = 3.11;95%CI: 1.91 to 5.07;P < 0.00001).The analysis did not support that age, gender, lumbar bone mineral density,preoperative visual analogue scale score, injected cement volume, intradiscalcement leakage, or vertebral height restoration could increase the risk forcemented vertebra recollapse after PVP in OVCFs.CONCLUSIONThis meta-analysis suggests that thoracolumbar junction fractures, preoperativeintravertebral cleft, and solid lump cement distribution pattern are associatedwith the recollapse of cemented vertebrae after PVP in OVCF patients.展开更多
目的探讨骨质疏松性椎体压缩骨折(OVCF)合并胸腰筋膜损伤(TFI)患者在椎体强化术后的临床疗效。方法选取2022年11月至2023年8月川北医学院附属医院骨科收治的81例采用经皮椎体球囊后凸成形术(PKP)治疗的OVCF患者为研究对象,根据是否合并...目的探讨骨质疏松性椎体压缩骨折(OVCF)合并胸腰筋膜损伤(TFI)患者在椎体强化术后的临床疗效。方法选取2022年11月至2023年8月川北医学院附属医院骨科收治的81例采用经皮椎体球囊后凸成形术(PKP)治疗的OVCF患者为研究对象,根据是否合并TFI进行分组,将合并TFI的患者作为TFI组(n=36),未合并TFI患者作为NTFI组(n=45)。比较两组患者年龄、性别、住院时间、骨密度等一般资料;手术时间、术中出血量、伤椎节段(T10-L2、L3-I5)占比、单侧或双侧穿刺占比、骨水泥注射量等术中指标。分别采用视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评估患者腰部疼痛程度和腰椎功能改善情况。结果两组患者伤椎节段占比、手术时间、术中出血量、单或双侧穿刺占比比较,差异均无统计学意义(P>0.05)。两组患者术前、术后3 d VAS、ODI评分比较,差异均无统计学意义(P>0.05)。TFI组患者术后1、3个月VAS、ODI评分均高于NTFI组患者(P<0.05)。结论TFI组患者在采用PKP治疗后3个月内,腰椎疼痛缓解程度和腰椎功能改善情况均较NTFI组患者差,TFI可作为OVCF合并TFI患者在椎体强化术后临床疗效观察的有效指标。展开更多
文摘BACKGROUND As one of the most common complications of osteoporosis,osteoporotic vertebral compression fracture(OVCF)increases the risk of disability and mortality in elderly patients.Percutaneous vertebroplasty(PVP)is considered to be an effective,safe,and minimally invasive treatment for OVCFs.The recollapse of cemented vertebrae is one of the serious complications of PVP.However,the risk factors associated with recollapse after PVP remain controversial.AIM To identify risk factors for the recollapse of cemented vertebrae after PVP in patients with OVCFs.METHODS A systematic search in EMBASE,MEDLINE,the Cochrane Library,and PubMed was conducted for relevant studies from inception until March 2020.Studies investigating risk factors for the recollapse of cemented vertebrae after PVP without additional trauma were selected for analysis.Odds ratios(ORs)or standardized mean differences with 95%confidence interval(CI)were calculated and heterogeneity was assessed by both the chi-squared test and the I-squared test.The methodological quality of the included studies was assessed according to the Newcastle-Ottawa Scale.RESULTS A total of nine case-control studies were included in our meta-analysis comprising 300 cases and 2674 controls.The significant risk factors for the recollapse of cemented vertebrae after PVP in OVCF patients were fractures located at the thoracolumbar junction(OR=2.09;95%CI:1.30 to 3.38;P=0.002),preoperative intravertebral cleft(OR=2.97;95%CI:1.93 to 4.57;P<0.00001),and solid lump distribution pattern of the cement (OR = 3.11;95%CI: 1.91 to 5.07;P < 0.00001).The analysis did not support that age, gender, lumbar bone mineral density,preoperative visual analogue scale score, injected cement volume, intradiscalcement leakage, or vertebral height restoration could increase the risk forcemented vertebra recollapse after PVP in OVCFs.CONCLUSIONThis meta-analysis suggests that thoracolumbar junction fractures, preoperativeintravertebral cleft, and solid lump cement distribution pattern are associatedwith the recollapse of cemented vertebrae after PVP in OVCF patients.
文摘目的探讨骨质疏松性椎体压缩骨折(OVCF)合并胸腰筋膜损伤(TFI)患者在椎体强化术后的临床疗效。方法选取2022年11月至2023年8月川北医学院附属医院骨科收治的81例采用经皮椎体球囊后凸成形术(PKP)治疗的OVCF患者为研究对象,根据是否合并TFI进行分组,将合并TFI的患者作为TFI组(n=36),未合并TFI患者作为NTFI组(n=45)。比较两组患者年龄、性别、住院时间、骨密度等一般资料;手术时间、术中出血量、伤椎节段(T10-L2、L3-I5)占比、单侧或双侧穿刺占比、骨水泥注射量等术中指标。分别采用视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评估患者腰部疼痛程度和腰椎功能改善情况。结果两组患者伤椎节段占比、手术时间、术中出血量、单或双侧穿刺占比比较,差异均无统计学意义(P>0.05)。两组患者术前、术后3 d VAS、ODI评分比较,差异均无统计学意义(P>0.05)。TFI组患者术后1、3个月VAS、ODI评分均高于NTFI组患者(P<0.05)。结论TFI组患者在采用PKP治疗后3个月内,腰椎疼痛缓解程度和腰椎功能改善情况均较NTFI组患者差,TFI可作为OVCF合并TFI患者在椎体强化术后临床疗效观察的有效指标。