[低骨水泥量椎体成形术后骨质疏松症患者骨折风险的前瞻性评估]

[Prospective evaluation of fracture risk in osteoporotic patients after low cement volume vertebroplasty].

作者信息

Cyteval C, Thomas E, Solignac D, Blin D, Decoux E, Lopez F M, Blotman F, Taourel P

机构信息

Service d'Imagerie Médicale, Hôpital Lapeyronie, Montpellier, France.

出版信息

J Radiol. 2008 Jun;89(6):797-801. doi: 10.1016/s0221-0363(08)73786-7.

DOI:10.1016/s0221-0363(08)73786-7

PMID:18641567

Abstract

PURPOSE

To prospectively compare the incidence of new fractures (as demonstrated on MR) within the first 3 months after an initial fracture in a population treated with low cement volume vertebroplasty and a population treated conservatively.

MATERIALS AND METHODS

From 49 patients admitted for osteoporotic vertebral compression fracture, 22 underwent CT guided vertebroplasty with injection of 1-3 ml of PMMA, and 27 were treated conservatively. All patients underwent MR at presentation and at 3 months to detect new compression fractures.

RESULTS

Twelve patients (54%) treated with vertebroplasty showed new fractures at 3 months compared to 10 (37%) in the control group. This was not statistically different (p=0.049). In the vertebroplasty group, the new fractures involved vertebrae adjacent to the treated vertebra in 77% of cases (p=0.009) compared to only 15% in the control group. During the 3-month period, 3 patients, including 2 treated with vertebroplasty, required hospital admission due to fracture related acute lumbar back pain.

CONCLUSION

The small amount of injected cement does not prevent fractures of adjacent vertebrae but does reduce the extravasation of PMMA in adjacent tissues.

摘要

目的

前瞻性比较低骨水泥量椎体成形术治疗人群和保守治疗人群初次骨折后前3个月内新骨折（磁共振成像显示）的发生率。

材料与方法

49例因骨质疏松性椎体压缩骨折入院的患者中，22例行CT引导下椎体成形术，注入1 - 3毫升聚甲基丙烯酸甲酯，27例接受保守治疗。所有患者在就诊时及3个月时均接受磁共振成像检查以检测新的压缩骨折。

结果

椎体成形术治疗的12例患者（54%）在3个月时出现新骨折，而对照组为10例（37%）。这在统计学上无显著差异（p = 0.049）。在椎体成形术组中，77%的新骨折累及治疗椎体相邻的椎体（p = 0.009），而对照组仅为15%。在3个月期间，3例患者，包括2例行椎体成形术治疗的患者，因骨折相关的急性腰背痛需住院治疗。