Lee Wan Soo, Sung Kyeong Hoon, Jeong Hyun Tae, Sung Youn Sang, Hyun Yong In, Choi Jae Young, Lee Kyu Seok, Ok Chul Su, Choi Young Woo
Neurosurgery, 21st Century Hospital, Seoul, Korea.
Eur Spine J. 2006 Dec;15(12):1777-83. doi: 10.1007/s00586-006-0151-7. Epub 2006 Jul 21.
Percutaneous vertebroplasty (PVP) is an efficient procedure to treat pain due to osteoporotic vertebral compression fractures (OVCFs). However, some patient populations experience recurrent vertebral fracture after initial successful procedure. There are a lot of literatures about the effectiveness of this procedure but few concerning the development of recurrent, new compression fracture. This is a retrospective review of all PVPs performed in author's institution from September 1999 to December 2001 to investigate the factors related to the development of new symptomatic OVCFs after PVPs. A retrospective review of 244 cases of PVP for symptomatic OVCFs at 382 levels was performed. Sociodemographic, clinical, radiologic, and procedural data were analyzed and compared between the two patient groups (control group : no further symptomatic OVCFs after the initial PVP, "new symptomatic fracture" group: with newly developed symptomatic OVCF). Statistical analysis was performed between the variables of the two groups. Survival analysis was performed using the Kaplan-Meier method. Over all, 38 among 244 treated patients (15.6%) had experienced newly developed symptomatic OVCF(s) during the follow up period (mean 52.5 months). Old age and the presence of multiple treated vertebrae at the initial PVP were assessed as a strong parameter for predicting new symptomatic OVCF. With increasing preoperative wedging deformity the risk of developing new symptomatic OVCF decreased. The Kaplan-Meier estimate of the 1 year fracture-free rate was 92.2%. The Kaplan-Meier curve showed that 7.8% of the patients would experience new symptomatic OVCF within 1 year after initial PVP. A preoperative only mild wedge deformity of the fractured vertebra(e) could indicate the increased risk of developing new symptomatic OVCF after vertebroplasty.
经皮椎体成形术（PVP）是治疗骨质疏松性椎体压缩骨折（OVCFs）所致疼痛的一种有效方法。然而，一些患者群体在初次手术成功后会再次发生椎体骨折。关于该手术有效性的文献众多，但涉及复发性新压缩骨折发生情况的却很少。这是一项对作者所在机构1999年9月至2001年12月期间进行的所有PVP手术的回顾性研究，旨在调查与PVP术后新的有症状OVCFs发生相关的因素。对244例有症状OVCFs行PVP治疗的382个椎体水平进行了回顾性研究。分析并比较了两组患者的社会人口统计学、临床、放射学和手术数据（对照组：初次PVP术后无进一步有症状的OVCFs；“新的有症状骨折”组：出现新的有症状的OVCF）。对两组变量进行了统计分析。采用Kaplan-Meier法进行生存分析。总体而言，244例接受治疗的患者中有38例（15.6%）在随访期间（平均52.5个月）出现了新的有症状的OVCF。高龄和初次PVP时治疗的椎体数量多被评估为预测新的有症状OVCF的有力参数。随着术前楔形变畸形程度增加，发生新的有症状OVCF的风险降低。1年无骨折率的Kaplan-Meier估计值为92.2%。Kaplan-Meier曲线显示，7.8%的患者在初次PVP术后1年内会出现新的有症状的OVCF。骨折椎体术前仅存在轻度楔形变可能表明椎体成形术后发生新的有症状OVCF的风险增加。
