Lo Yang-Pin, Chen Wen-Jer, Chen Lih-Huei, Lai Po-Liang
Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan.
J Trauma. 2008 Dec;65(6):1439-45. doi: 10.1097/TA.0b013e318169cd0b.
Because the complications of vertebroplasty are serious and can include new fracture, we retrospectively evaluated potential risk factors for new fracture after vertebroplasty. Our hypothesis is that thoracolumbar vertebrae adjacent to a vertebroplasty site have a higher incidence of new compression fracture than do other vertebrae.
Between March 2001 and December 2002, a total of 271 patients underwent vertebroplasty and a retrospective review of charts was performed. Patients reached 24 months of follow-up were included for analyses. Age, gender, bone mineral density, the numbers of prior vertebroplasty procedures, cement volume, postoperative kyphotic angle, the vertebral level, and kyphotic changes were assessed in relation to surgical outcome.
The 220 patients had a mean age of 72.7 years (range, 53-97 years) and a mean follow-up interval of 25.6 months (range, 24-36 months). A total of 15 patients had 18 new fractures, and 11 new fractures were at the thoracolumbar junction (T12-L1) (p = 0.61). New fractures were in vertebrae adjacent to a treated vertebra in 55.6% (10 of 18 cases) of cases. Analysis of potential predictors for new vertebral fracture failed to identify statistically significant risk factors, despite a large sample size.
Overall, 6.16% (18 of 292) of all treated vertebra developed associated new vertebral fractures. Cranial vertebrae were most likely to fracture at the adjacent level, whereas thoracic vertebrae were least likely to fracture at the adjacent level. Additional risk factors for new vertebral fracture are poorly understood.
由于椎体成形术的并发症较为严重，可能包括新发骨折，我们对椎体成形术后新发骨折的潜在危险因素进行了回顾性评估。我们的假设是，椎体成形术部位相邻的胸腰椎发生新发压缩性骨折的发生率高于其他椎体。
2001年3月至2002年12月期间，共有271例患者接受了椎体成形术，并对病历进行了回顾性分析。纳入随访满24个月的患者进行分析。评估年龄、性别、骨密度、既往椎体成形术的次数、骨水泥用量、术后后凸角、椎体节段以及后凸变化与手术结果的关系。
220例患者的平均年龄为72.7岁（范围53 - 97岁），平均随访时间为25.6个月（范围24 - 36个月）。共有15例患者发生了18处新发骨折，其中11处新发骨折位于胸腰段交界（T12 - L1）（p = 0.61）。18例中有10例（55.6%）新发骨折发生在治疗椎体相邻的椎体。尽管样本量较大，但对新发椎体骨折潜在预测因素的分析未能确定具有统计学意义的危险因素。
总体而言，所有接受治疗的椎体中有6.16%（292例中的18例）发生了相关新发椎体骨折。上位椎体在相邻节段最易发生骨折，而下位椎体在相邻节段最不易发生骨折。新发椎体骨折的其他危险因素尚不清楚。
