Division of Orthopedic Surgery, Changhua Christian Hospital, Changhua, Taiwan, Republic of China.
Spine (Phila Pa 1976). 2012 Feb 1;37(3):179-83. doi: 10.1097/BRS.0b013e3181f72b05.
A retrospective review and analysis of consecutive patients who underwent single-level vertebroplasty at our institute between March 2002 and March 2006.
To analyze the risk factors for subsequent fractures after vertebroplasty and to predict the postoperative fracture-free time and rate. The effect of bone cement volume injected was also evaluated.
Previous studies of subsequent fractures after vertebroplasty showed conflicting conclusions about risk factors. The frequency of refracture also varied, ranging from 12% to 52%. Most new fractures occurred at adjacent levels, with different risk factors identified. No data were available on the effect of injected bone cement volume, and no consensus had been reached as to the optimal cement volume.
All enrolled patients were treated with single-level vertebroplasty and followed a standardized postoperative care protocol. Data from medical records and radiographs were collected and analyzed. Variables included patient constitutional factors, radiographic parameters, and volume of injected bone cement.
A total of 166 patients (76 men, 90 women) with a mean age of 73.4 years were enrolled in this study. The mean follow-up time was 15.3 months. The overall refracture rate was 38%, with a mean fracture-free interval of 32 months. Both a greater volume of bone cement injected and a greater degree of vertebral height restored contributed significantly to the risk of subsequent adjacent fracture. No risk factor for subsequent remote fracture was identified. A greater volume of bone cement injected was positively correlated with deformity correction after vertebroplasty.
Most subsequent fractures occurred at the adjacent level within the first 3 months. Patient preoperative condition did not help predict refracture. Although a greater volume of bone cement injected when performing vertebroplasty contributed to the risk of subsequent adjacent fracture, it resulted in a greater improvement of kyphosis.
回顾性分析我院 2002 年 3 月至 2006 年 3 月期间行单节段椎体成形术的连续患者。
分析椎体成形术后再骨折的危险因素，预测术后无骨折时间和发生率。评估注入骨水泥量的影响。
椎体成形术后再骨折的既往研究得出的危险因素结论相互矛盾。再骨折的频率也不同，范围为 12%至 52%。大多数新骨折发生在相邻水平，确定了不同的危险因素。关于注入骨水泥量的影响没有数据，也没有达成关于最佳水泥量的共识。
所有入组患者均行单节段椎体成形术治疗，并遵循标准化的术后护理方案。收集并分析病历和影像学资料。变量包括患者体质因素、影像学参数和注入骨水泥量。
本研究共纳入 166 例患者（76 例男性，90 例女性），平均年龄 73.4 岁。平均随访时间为 15.3 个月。总体再骨折率为 38%，平均无骨折间隔为 32 个月。注入骨水泥量较大和椎体高度恢复程度较大均显著增加了发生相邻再骨折的风险。未发现发生远处再骨折的危险因素。注入骨水泥量越大，椎体成形术后畸形矫正效果越好。
大多数再骨折发生在术后 3 个月内的相邻水平。患者术前情况无助于预测再骨折。虽然椎体成形术中注入较大体积的骨水泥会增加发生相邻再骨折的风险，但会导致后凸畸形更大程度的改善。
