Department of Radiology, Kansai Medical University, Hirakata Hospital, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191, Japan.
AJR Am J Roentgenol. 2011 Jun;196(6):1415-8. doi: 10.2214/AJR.10.5586.
The purpose of this article is to evaluate the technical and clinical outcomes of 194 patients with 500 osteoporotic vertebral compression fractures (VCFs) consecutively treated by percutaneous vertebroplasty, to investigate the long-term efficacy of percutaneous vertebroplasty, and to determine the frequency of new VCFs after percutaneous vertebroplasty.
One hundred ninety-four patients (168 women and 26 men; mean age, 73.3 years; range, 44-89 years) with 500 VCFs (T5-L5) were enrolled in this study. Evaluation at each follow-up time point (1 day, 1 month, 4 months, 1 year, and then once yearly) included pain response by using a pain visual analog scale (VAS) and frontal and lateral radiographs of the thoracic and lumbar vertebrae regardless of the symptoms.
The mean volume of cement injected was 3.3 mL (range, 0.5-12 mL) per level. Cement leakage was seen at 213 levels (42.6%). The mean follow-up time was 31 months (range, 1-97 months). The mean VAS score was 7.6 before percutaneous vertebroplasty and 3.1 at 1 day, 2.3 at 1 month, 1.7 at 4 months, 1.5 at 1 year, 1.2 at 2 years, 1.0 at 3 years, 1.1 at 4 years, 0.9 at 5 years, 0.9 at 6 years, and 1.0 at 7 years after percutaneous vertebroplasty. New VCFs were confirmed in 103 vertebrae in 65 patients (33.5%), affecting 65 adjacent vertebrae (63.1%) and 38 nonadjacent vertebrae (36.9%).
Percutaneous vertebroplasty was effective in relieving the pain associated with osteoporosis-induced VCFs, and the analgesic effect was long lasting when no new VCF occurred. However, radiologic follow-up observation showed that new VCFs occurred in approximately one-third of the patients.
本文旨在评估 194 例 500 例骨质疏松性椎体压缩性骨折（VCF）患者行经皮椎体成形术的技术和临床结果，探讨经皮椎体成形术的长期疗效，并确定经皮椎体成形术后新 VCF 的发生频率。
本研究共纳入 194 例（168 例女性，26 例男性；平均年龄 73.3 岁；年龄范围 44-89 岁）500 例 VCF（T5-L5）患者。每次随访时间点（1 天、1 个月、4 个月、1 年，然后每年一次）的评估均包括使用疼痛视觉模拟量表（VAS）评估疼痛反应以及拍摄胸椎和腰椎的前后位 X 线片，无论症状如何。
每节段注射的平均水泥量为 3.3mL（范围 0.5-12mL）。213 个节段（42.6%）可见水泥渗漏。平均随访时间为 31 个月（范围 1-97 个月）。经皮椎体成形术前平均 VAS 评分为 7.6，1 天为 3.1，1 个月为 2.3，4 个月为 1.7，1 年为 1.5，2 年为 1.2，3 年为 1.0，4 年为 1.1，5 年为 0.9，6 年为 0.9，7 年为 1.0。65 例患者（33.5%）的 103 个椎体出现新的 VCF，影响 65 个相邻椎体（63.1%）和 38 个非相邻椎体（36.9%）。
经皮椎体成形术可有效缓解骨质疏松性 VCF 引起的疼痛，且在无新 VCF 发生时，镇痛效果持久。然而，影像学随访观察显示，约有三分之一的患者出现新的 VCF。
