McKiernan Fergus, Faciszewski Tom, Jensen Ron
Center for Bone Diseases, Department of Orthopedic Spine Surgery, Marshfield Clinic, 1000 North Oak, Marshfield, Wisconsin 54449, USA.
J Vasc Interv Radiol. 2006 Sep;17(9):1479-87. doi: 10.1097/01.RVI.0000235742.26624.37.
To describe the property of latent mobility in osteoporotic vertebral compression fractures (VCFs) and discuss its clinical significance.
This was a retrospective case series of 14 patients with 14 painful osteoporotic VCFs who were comfortably confined to the supine position overnight for the purpose of vertebral height restoration. There was sufficient additional vertebral height restoration the following morning to allow percutaneous vertebroplasty (PV) in some patients when this had initially been deemed unsafe or technically impossible. Anterior vertebral height of the index VCF was measured from the preoperative standing lateral, immediate cross-table supine lateral, and postconfinement cross-table supine lateral radiographs as well as the first postoperative standing lateral radiograph. Dynamic mobility was defined as the difference in anterior vertebral height between preoperative standing lateral and immediate cross-table supine lateral radiographs. Latent mobility was defined as difference in anterior vertebral height between immediate cross-table supine lateral and postconfinement cross-table supine lateral radiographs. Postoperative vertebral height restoration was defined as the difference in anterior vertebral height between preoperative and first postoperative standing lateral radiographs. Mean patient age was 81.0 years, and mean fracture age was 83.6 days.
Dynamic mobility averaged +4.7 mm (range, -2.1 to +12.6 mm; P = .001). Latent mobility averaged +2.7 mm (range, -1.9 to +15.5; P < .02). The average sum of preoperative dynamic and latent mobility (+7.4 mm; range -1.0 to +17.0; P < .001) was not different from final postoperative vertebral height restoration (P > .4). PV was successfully accomplished in all cases.
Latent mobility occurs in some VCFs and contributes to vertebral height restoration. Recognition of latent mobility may permit vertebroplasty in some patients in whom the procedure had otherwise been deemed unsafe. Reports of vertebral height restoration following vertebral augmentation should account for that proportion resulting from dynamic and latent mobility.
描述骨质疏松性椎体压缩骨折（VCF）中潜在移动性的特性，并探讨其临床意义。
这是一项回顾性病例系列研究，纳入了14例患有14处疼痛性骨质疏松性VCF的患者，为恢复椎体高度，患者舒适地仰卧过夜。次日早晨，部分患者出现了足够的额外椎体高度恢复，使得最初被认为不安全或技术上不可能进行的经皮椎体成形术（PV）成为可能。从术前站立位侧位、即刻床旁仰卧位侧位、卧床后床旁仰卧位侧位X线片以及术后第一张站立位侧位X线片测量索引VCF的椎体前缘高度。动态移动性定义为术前站立位侧位与即刻床旁仰卧位侧位X线片之间椎体前缘高度的差值。潜在移动性定义为即刻床旁仰卧位侧位与卧床后床旁仰卧位侧位X线片之间椎体前缘高度的差值。术后椎体高度恢复定义为术前与术后第一张站立位侧位X线片之间椎体前缘高度的差值。患者平均年龄为81.0岁，骨折平均时间为83.6天。
动态移动性平均为+4.7毫米（范围为-2.1至+12.6毫米；P = 0.001）。潜在移动性平均为+2.7毫米（范围为-1.9至+15.5；P < 0.02）。术前动态和潜在移动性的平均总和（+7.4毫米；范围为-1.0至+17.0；P < 0.001）与术后最终椎体高度恢复无差异（P > 0.4）。所有病例均成功完成PV。
部分VCF存在潜在移动性，有助于椎体高度恢复。认识到潜在移动性可能使一些原本被认为不安全的患者能够接受椎体成形术。椎体强化术后椎体高度恢复的报告应说明动态和潜在移动性所导致的恢复比例。
