Department of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan.
AJNR Am J Neuroradiol. 2012 Jan;33(1):57-60. doi: 10.3174/ajnr.A2726. Epub 2011 Oct 13.
Many authors have reported the increase in vertebral body height after vertebroplasty. However, McKiernan et al demonstrated dynamic mobility in patients who underwent vertebroplasty and concluded that any article that claims vertebral height restoration must control for the dynamic mobility of fractured vertebrae. The purpose of this study was to compare prevertebroplasty (supine cross-table with a bolster beneath) with postvertebroplasty vertebral body height to find out whether vertebroplasty itself really increases the vertebral height.
From July 2005 to July 2010, 102 consecutive patients with 132 VCFs underwent vertebroplasty at our institution. The indications for vertebroplasty were severe pain that was not responsive to medical treatment, and MR imaging-confirmed edematous lesions. Prevertebroplasty (supine cross-table with bolster beneath) lateral radiographs were compared with postvertebroplasty radiographs to evaluate the height change in vertebroplasty. Kyphotic angle and anterior vertebral body height were measured.
The patients ranged in age from 62 to 90 years. There were 16 men and 86 women. The difference in the kyphotic angle between supine cross-table with bolster and postvertebroplasty was -0.49 ± 3.59° (range, -9°-16°), which was not statistically significant (P = 0.124). The difference in the anterior vertebral body height between supine cross-table with bolster and postvertebroplasty was 0.84 ± 3.01 mm (range, -7.91-8.81 mm), which was statistically significant (P = .002).
The restoration of vertebral body height in vertebroplasty seems to be mostly due to the dynamic mobility of fractured vertebrae; vertebroplasty itself does not contribute much to the restoration of vertebral height.
许多作者已经报道了椎体成形术后椎体高度的增加。然而，McKiernan 等人在接受椎体成形术的患者中发现了动态活动性，并得出结论，任何声称恢复椎体高度的文章都必须控制骨折椎体的动态活动性。本研究的目的是比较椎体成形术前（仰卧位交叉桌，下方垫枕）与术后椎体体高度，以确定椎体成形术本身是否真的增加了椎体高度。
2005 年 7 月至 2010 年 7 月，我院对 102 例 132 例 VCF 患者进行了椎体成形术。椎体成形术的适应证为严重疼痛，药物治疗无效，且 MRI 证实有水肿病变。比较了椎体成形术前（仰卧位交叉桌，下方垫枕）和术后的侧位 X 线片，以评估椎体成形术后椎体高度的变化。测量后凸角和椎体前缘高度。
患者年龄 62-90 岁，男 16 例，女 86 例。仰卧位交叉桌垫枕与术后后凸角的差异为-0.49±3.59°（范围-9°-16°），无统计学意义（P=0.124）。仰卧位交叉桌垫枕与术后椎体前缘高度的差异为 0.84±3.01mm（范围-7.91-8.81mm），有统计学意义（P=0.002）。
椎体成形术后椎体高度的恢复似乎主要是由于骨折椎体的动态活动性；椎体成形术本身对椎体高度的恢复贡献不大。
