Department of Radiology, Inha University Hospital, Incheon, 400-711, Korea.
Skeletal Radiol. 2010 Aug;39(8):757-66. doi: 10.1007/s00256-009-0866-8. Epub 2010 Feb 9.
To investigate the short-term therapeutic effect of percutaneous vertebroplasty (PVP) for intravertebral cleft (IVC) and to analyze possible outcome predictors.
After retrospective review of spot radiographs during PVP, 23 patients were included in this study. Age, sex, symptom duration, functional status, injected cement volume, and type of approach were evaluated using patients' medical and operative records. The following factors were analyzed on radiographs, MRI, dual bone densitometry, spot radiographs during PVP, and CT: anatomical location of the fracture, bone mineral density, morphology of the fracture, IVC morphology, presence of surrounding non-enhanced area and bone marrow edema, degeneration of adjacent discs, co-existing old compression fractures, patterns of cement opacification, pre-procedural kyphosis, and post-procedural kyphosis correction. Effectiveness was defined as a much-improved state or no pain after 1 week, 1 month, and 2 months. Statistical analyses were conducted to evaluate the relationship between those factors and therapeutic outcome using Fisher's exact test, Chi-squared test, and the Mann-Whitney U test.
Percutaneous vertebroplasty of IVC was effective in 16 out of 23 (69.6%) patients after 1 week and 1 month and 15 out of 23 (65.2%) patients after 2 months. Post-procedural kyphosis correction >or=5 and poor functional status (full dependency) were more common in the ineffective group after 1 week and 2 months respectively (P = 0.047, P = 0.02). Kyphotic correction >or=5 was related to pre-procedural kyphosis >or=15 (P = 0.018). Functional status was related to subsequent fracture (P = 0.005). Other factors were not statistically significant (P > 0.05).
Percutaneous vertebroplasty on osteoporotic vertebral compression fractures (VCF) with IVC was effective in only about 69.6% of patients after the first week and month and in 65.2% of patients after 2 months. Post-procedural kyphosis correction >or=5 was associated with poor outcomes after the first week. Two months after PVP, the functional status was more important because of the development of subsequent fractures.
研究经皮椎体成形术（PVP）治疗椎体内裂隙（IVC）的短期疗效，并分析可能的预后预测因素。
回顾性分析 PVP 术中的点片，纳入 23 例患者。使用患者的病历和手术记录评估年龄、性别、症状持续时间、功能状态、注入的水泥量和入路类型。在影像学、MRI、双能骨密度、PVP 术中点片和 CT 上分析以下因素：骨折的解剖位置、骨密度、骨折形态、IVC 形态、周围无增强区和骨髓水肿、相邻椎间盘退变、并存陈旧性压缩骨折、水泥显影模式、术前后凸畸形和术后后凸畸形矫正。术后 1 周、1 个月和 2 个月时，疼痛缓解或明显缓解定义为有效。采用 Fisher 确切检验、卡方检验和 Mann-Whitney U 检验对这些因素与治疗效果之间的关系进行统计学分析。
23 例患者中，16 例（69.6%）在术后 1 周和 1 个月时、15 例（65.2%）在术后 2 个月时经皮椎体成形术治疗 IVC 有效。术后 1 周和 2 个月时，后凸畸形矫正>或=5 度和功能状态差（完全依赖）在无效组中更为常见（P = 0.047，P = 0.02）。后凸畸形矫正>或=5 度与术前后凸畸形>或=15 度有关（P = 0.018）。功能状态与随后的骨折有关（P = 0.005）。其他因素无统计学意义（P > 0.05）。
对于骨质疏松性椎体压缩性骨折（VCF）伴 IVC 的患者，经皮椎体成形术在术后第 1 周和第 1 个月有效率约为 69.6%，在术后 2 个月有效率为 65.2%。术后后凸畸形矫正>或=5 度与术后第 1 周疗效不佳有关。在 PVP 术后 2 个月时，由于随后发生骨折，功能状态更为重要。
