Kim S H, Kang H S, Choi J A, Ahn J M
Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang-gu, Seongnam-si, Gyunggi-do, Korea.
Acta Radiol. 2004 Jul;45(4):440-5. doi: 10.1080/02841850410005615.
To evaluate the risk factors related to the development of new fractures in adjacent vertebrae after vertebroplasty.
The study was conducted on 106 patients in whom 212 vertebroplasties were performed during a period of 3 years. Evaluations of the five vertebrae superior and inferior to the treated vertebra were performed. Consequently, 913 vertebrae were evaluated and the fracture-free interval of the vertebral body adjacent to the treated vertebra was calculated. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards regression analysis.
Seventy-two (7.9%) new fractures were revealed. The Kaplan-Meier estimate of the 1-year fracture-free rate was 93.1%. The mean fracture-free interval was 32 months (95% CI, 32 to approximately 33 months). The greater degree of height restoration of the treated vertebra, the location of the adjacent vertebra in the TL junction, and the shorter distance between the treated and the adjacent vertebra increased the risk of new vertebral fractures.
Thoracolumbar junction, shorter distance from the treated vertebrae, and greater degree of height restoration of the cemented vertebrae may increase the fracture risk of vertebrae adjacent to cement vertebrae after vertebroplasty.
评估椎体成形术后相邻椎体发生新发骨折的相关危险因素。
对106例患者进行了研究，在3年期间共实施了212次椎体成形术。对治疗椎体上下各五个椎体进行了评估。因此，共评估了913个椎体，并计算了与治疗椎体相邻椎体的无骨折间隔时间。采用Kaplan-Meier法和Cox比例风险回归分析进行生存分析。
发现72例（7.9%）新发骨折。1年无骨折率的Kaplan-Meier估计值为93.1%。平均无骨折间隔时间为32个月（95%可信区间，32至约33个月）。治疗椎体的高度恢复程度越高、相邻椎体位于胸腰段交界处以及治疗椎体与相邻椎体之间的距离越短，新发椎体骨折的风险越高。
胸腰段交界处、与治疗椎体的距离较短以及骨水泥填充椎体的高度恢复程度较高，可能会增加椎体成形术后骨水泥椎体相邻椎体的骨折风险。
