Department of Orthopaedic Surgery, NorthShore University HealthSystems, University of Chicago, 2650 Ridge Ave, Evanston, IL 60201, USA.
Spine J. 2010 Feb;10(2):153-8. doi: 10.1016/j.spinee.2009.11.018.
During the last decade, vertebral augmentation techniques with cement (kyphoplasty and vertebroplasty) have revealed that 75% to 100% of individuals with osteoporotic vertebral compression fractures have good to moderate pain relief postoperatively, as well as adequate restoration of the vertebral body height. The volume of cement injected into a vertebra varied in different reports. To our knowledge, there are no studies that report on the physiological distribution of thoracic and lumbar vertebrae body volumes.
The purpose of this study was to quantitatively evaluate thoracic and lumbar vertebral body volumes.
STUDY DESIGN/SETTING: Forty computed tomography (CT) scans of the thoracic and lumbar spines were used to measure a volume of each vertebral body.
Forty CT scans with standard 2.5-mm bone window cuts of the thoracic and lumbar vertebrae (20 men and 20 women) were analyzed to measure the volumetric capacity of vertebral bodies using a BrainLAB Software (iPlan RT image 4.0) program. The software was tested for validity and reliability in two pilot studies. Mean and standard deviations for each vertebral body volume were calculated and recorded. The vertebral body working distance and the so-called "safe zone" were also measured to determine a size of a balloon to be used in kyphoplasty.
Vertebral body volume increased gradually from T1 to L4 with the exception of L5, which measured to be smaller than L4. The mean thoracic vertebrae volume was 15.0 cm(3) (ranged in the absolute values from 5.2 to 39.5 cm(3)), and the mean lumbar vertebrae volume was 35 cm(3) (ranged in the absolute values from 19.7 to 61.5 cm(3)). Men had larger volume vertebral bodies only in the lumbar spine compared with women. The average vertebral body working distances from T1 to T4 was 23.4+/-2.7 mm, from T5 to T9 was 30.3+/-3.6 mm, and from T10 to L5 was 35.5+/-3.9 mm.
Knowing the physiological variability of vertebral body volumes may help prevent complications as a result of underaugmentation or overaugmentation with excessive amount of cement during kyphoplasty or vertebroplasty in osteoporotic compression fractures. We recommend using 10 mm balloons from T1 to T4, 15 mm balloons from T5 to T9, and 20 mm balloons from T10 to L5 for kyphoplasty.
在过去的十年中，使用水泥的椎体增强技术（后凸成形术和椎体成形术）已经表明，75%至 100%的骨质疏松性椎体压缩性骨折患者术后疼痛缓解良好至中度，并且椎体高度得到充分恢复。不同报道中注入椎体的水泥量有所不同。据我们所知，尚无研究报告胸腰椎体体积的生理分布。
本研究的目的是定量评估胸腰椎体体积。
研究设计/设置：使用 40 例胸腰椎 CT 扫描来测量每个椎体的体积。
分析 40 例胸腰椎骨窗标准 2.5mm 的 CT 扫描（20 名男性和 20 名女性），使用 BrainLAB 软件（iPlan RT image 4.0）程序测量椎体的容量。该软件在两项试点研究中进行了有效性和可靠性测试。计算并记录每个椎体体积的平均值和标准差。还测量了椎体工作距离和所谓的“安全区”，以确定后凸成形术中球囊的大小。
椎体体积从 T1 逐渐增加到 L4，除 L5 外，L5 比 L4 小。胸腰椎平均体积为 15.0cm³（绝对值范围为 5.2 至 39.5cm³），平均腰椎体积为 35cm³（绝对值范围为 19.7 至 61.5cm³）。与女性相比，男性只有在腰椎才有更大的体积椎体。从 T1 到 T4 的平均椎体工作距离为 23.4+/-2.7mm，从 T5 到 T9 为 30.3+/-3.6mm，从 T10 到 L5 为 35.5+/-3.9mm。
了解椎体体积的生理变异性可以帮助预防骨质疏松性压缩性骨折后凸成形术或椎体成形术中因水泥填充不足或过量而导致的并发症。我们建议在 T1 到 T4 使用 10mm 球囊，在 T5 到 T9 使用 15mm 球囊，在 T10 到 L5 使用 20mm 球囊进行后凸成形术。
