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骨质疏松性椎体骨折椎体成形术后一年椎体高度增加及椎体几何形态稳定

Height gain of vertebral bodies and stabilization of vertebral geometry over one year after vertebroplasty of osteoporotic vertebral fractures.

作者信息

Pitton Michael B, Morgen Nadine, Herber Sascha, Drees Philipp, Böhm Bertram, Düber Christoph

机构信息

Department of Diagnostic and Interventional Radiology, University Hospital of Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany.

出版信息

Eur Radiol. 2008 Mar;18(3):608-15. doi: 10.1007/s00330-007-0776-x. Epub 2007 Oct 2.

Abstract

The height gain of vertebral bodies after vertebroplasty and geometrical stability was evaluated over a one-year period. Osteoporotic fractures were treated with vertebroplasty. The vertebral geometry and disc spaces were analysed using reformatted computed tomography (CT) images: heights of the anterior, posterior, and lateral vertebral walls, disc spaces, endplate angles, and minimal endplate distances. Vertebrae were assigned to group I [severe compression (anterior height/posterior height) <0.75] and group II (moderate compression index >0.75). A total of 102 vertebral bodies in 40 patients (12 men, 28 women, age 70.3 +/- 9.5) were treated with vertebroplasty and prospectively followed for 12 months. Group I showed a greater benefit compared with group II with respect to anterior height gain (+2.1 +/- 1.9 vs +0.7 +/- 1.6 mm, P < 0.001), reduction of endplate angle (-3.6 +/- 4.2 vs -0.8 +/- 2.3 degrees , P < 0.001), and compression index (+0.09 +/- 0.11 vs +0.01 +/- 0.06, P < 0.001). At one-year follow-up, group I demonstrated preserved anterior height gain (+1.5 +/- 2.8 mm, P < 0.015) and improved endplate angle (-3.4 +/- 4.9 degrees , P < 0.001). In group II, the vertebral heights returned to and were fixed at the pre-interventional levels. Vertebroplasty provided vertebral height gain over one year, particularly in cases with severe compression. Vertebrae with moderate compression were fixed and stabilized at the pre-treatment level over one year.

摘要

在一年的时间里评估了椎体成形术后椎体高度增加情况及几何稳定性。对骨质疏松性骨折采用椎体成形术治疗。使用重组计算机断层扫描(CT)图像分析椎体几何形状和椎间隙:椎体前、后、外侧壁高度、椎间隙、终板角度和最小终板距离。将椎体分为I组[严重压缩(前高度/后高度)<0.75]和II组(中度压缩指数>0.75)。40例患者(12例男性,28例女性,年龄70.3±9.5岁)的102个椎体接受了椎体成形术,并进行了为期12个月的前瞻性随访。I组在椎体前高度增加(+2.1±1.9 vs +0.7±1.6 mm,P<0.001)、终板角度减小(-3.6±4.2 vs -0.8±2.3度,P<0.001)和压缩指数(+0.09±0.11 vs +0.01±0.06,P<0.001)方面比II组显示出更大的益处。在一年的随访中,I组显示椎体前高度增加得以保持(+1.5±2.8 mm,P<0.015)且终板角度改善(-3.4±4.9度,P<0.001)。在II组中,椎体高度恢复并固定在干预前水平。椎体成形术在一年内使椎体高度增加,特别是在严重压缩的病例中。中度压缩的椎体在一年中固定并稳定在治疗前水平。

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