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:观察经皮后凸椎体成形术(PKP)联合术中胸椎旁神经阻滞治疗骨质疏松胸椎压缩性骨折(OTCF)的临床疗效。方法:将50例OTCF伴非轴性痛患者根据术中是否行胸椎旁神经阻滞随机分为两组,观察组(PKP联合胸椎旁神经阻滞)和对照组(单纯PKP)各2...目的:观察经皮后凸椎体成形术(PKP)联合术中胸椎旁神经阻滞治疗骨质疏松胸椎压缩性骨折(OTCF)的临床疗效。方法:将50例OTCF伴非轴性痛患者根据术中是否行胸椎旁神经阻滞随机分为两组,观察组(PKP联合胸椎旁神经阻滞)和对照组(单纯PKP)各25例。比较两组患者术前及术后1天、1周、1月及3月胸背肋间痛、腰椎功能及患者满意度情况,分别采用视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)及患者满意度测评进行评价。结果:两组患者术后1天、1周、1月、3月胸背肋间痛VAS评分及ODI评分均呈明显下降趋势(均P<0.05)。观察组术后1天(2.72±1.04 vs 3.36±1.13)及术后1周(2.44±0.94 vs 2.96±1.11)VAS评分明显低于对照组(均P<0.05),两组患者各时间点ODI评分比较无明显差异。术后1天(92%vs 68%)及术后1周(100%vs 84%)患者满意度明显高于对照组(均P<0.05)。结论:PKP联合术中胸椎旁神经阻滞可有效缓解OTCF患者术后早期非轴性疼痛程度,提高患者满意度。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:观察经皮后凸椎体成形术(PKP)联合术中胸椎旁神经阻滞治疗骨质疏松胸椎压缩性骨折(OTCF)的临床疗效。方法:将50例OTCF伴非轴性痛患者根据术中是否行胸椎旁神经阻滞随机分为两组,观察组(PKP联合胸椎旁神经阻滞)和对照组(单纯PKP)各25例。比较两组患者术前及术后1天、1周、1月及3月胸背肋间痛、腰椎功能及患者满意度情况,分别采用视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)及患者满意度测评进行评价。结果:两组患者术后1天、1周、1月、3月胸背肋间痛VAS评分及ODI评分均呈明显下降趋势(均P<0.05)。观察组术后1天(2.72±1.04 vs 3.36±1.13)及术后1周(2.44±0.94 vs 2.96±1.11)VAS评分明显低于对照组(均P<0.05),两组患者各时间点ODI评分比较无明显差异。术后1天(92%vs 68%)及术后1周(100%vs 84%)患者满意度明显高于对照组(均P<0.05)。结论:PKP联合术中胸椎旁神经阻滞可有效缓解OTCF患者术后早期非轴性疼痛程度,提高患者满意度。
