Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
AJR Am J Roentgenol. 2010 Sep;195(3):W207-12. doi: 10.2214/AJR.10.4195.
The purpose of this prospective study was to evaluate maintenance of spinal canal size and restoration of vertebral height and wedge angle after percutaneous vertebroplasty.
This study included 27 patients (19 women, eight men) with osteoporotic compression fractures (52 vertebrae). MDCT with multiplanar reformation was performed within 1 day before and 1 hour after the procedure and 1 year after the procedure on a routine or as-needed basis. The degree of retropulsion, smallest size of the spinal canal, and vertebral height and wedge angle were measured. Statistical analyses were performed with the paired Student's t and Mann-Whitney U tests.
There were no statistically significant differences in degree of retropulsion or size of the spinal canal before and after treatment and at the follow-up evaluation (p > 0.05). Even in the 36 vertebrae with spinal canal compromise before the procedure, there was no significant change in spinal stenosis (p > 0.05). Vertebral height and wedge angle were restored immediately after treatment (1.2 mm and 2.8 degrees , p < 0.05). These restorations were more prominent in vertebrae with fracture clefts than in those without clefts (p < 0.05). Restoration of vertebral height and wedge angle were diminished, but the preprocedure results were maintained in follow-up (0.4 mm and 1.1 degrees , p > 0.05).
Vertebroplasty can maintain vertebral height and wedge angle and spinal canal size at least 1 year after treatment.
本前瞻性研究旨在评估经皮椎体成形术后脊柱管大小的维持情况以及椎体高度和楔角的恢复情况。
本研究纳入了 27 名（19 名女性，8 名男性）骨质疏松性压缩性骨折患者（52 个椎体）。在手术前 1 天内、手术后 1 小时内以及手术后 1 年，使用 MDCT 进行多平面重建，并根据需要进行常规检查。测量了后凸程度、椎管最小径、椎体高度和楔角。采用配对学生 t 检验和曼-惠特尼 U 检验进行统计学分析。
治疗前后及随访时的后凸程度或椎管大小均无统计学差异（p > 0.05）。即使在术前椎管受压的 36 个椎体中，椎管狭窄也没有明显变化（p > 0.05）。椎体高度和楔角在治疗后即刻得到恢复（1.2mm 和 2.8 度，p < 0.05）。在有骨折裂隙的椎体中，这些恢复更为明显，而在无裂隙的椎体中则不明显（p < 0.05）。椎体高度和楔角的恢复虽然有所减弱，但在随访时仍保持了术前的结果（0.4mm 和 1.1 度，p > 0.05）。
经皮椎体成形术至少可在治疗后 1 年内维持椎体高度、楔角和椎管大小。
