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经皮椎体成形术后骨质疏松性压缩骨折患者的放射学发现是疼痛缓解的有利预测因素:156 例回顾性研究。

Radiological findings as favorable predictors of pain relief in patients with osteoporotic compression fractures after percutaneous vertebroplasty: a retrospective study of 156 cases.

机构信息

Department of Radiology, St. Luke's International Hospital, Tokyo, Japan.

出版信息

Jpn J Radiol. 2012 Jun;30(5):407-14. doi: 10.1007/s11604-012-0062-y. Epub 2012 Feb 28.

Abstract

PURPOSE

We evaluated the relationships between pre-procedural radiological findings and short-term pain relief in patients with osteoporotic compression fractures after percutaneous vertebroplasty (PVP).

MATERIALS AND METHODS

A retrospective review of pre-procedural radiological images of 156 patients with painful osteoporotic compression fracture was performed. Pain was measured with a visual analogue scale (VAS). Complete pain relief was defined as a VAS pain score of 0 or 1 at 3 months after PVP. Statistical analyses were conducted to evaluate the relationship between the pre-procedural imaging factors and pain relief using Pearson's chi-squared test. Multivariate logistic regression analysis was also performed.

RESULTS

Complete pain relief was obtained in 45.5% of patients. An intravertebral cleft larger than half the height of the fractured vertebral body (FVB) was a significant key factor in the complete pain relief group after 3 months. Further, ≥40% of the spinal canal occupied by bony fragments of the FVB was related to incomplete pain relief.

CONCLUSION

A large intravertebral cleft was a favorable short-term outcome predictor in patients with osteoporotic compression fractures after PVP, while severe protrusion of the FVB causing lumbar spinal canal stenosis was not a favorable short-term outcome predictor of complete pain relief.

摘要

目的

我们评估了经皮椎体成形术(PVP)治疗骨质疏松性压缩性骨折患者术前影像学表现与短期疼痛缓解之间的关系。

材料与方法

回顾性分析了 156 例伴疼痛性骨质疏松性压缩性骨折患者的术前影像学图像。疼痛采用视觉模拟评分(VAS)进行评估。PVP 后 3 个月时 VAS 疼痛评分为 0 或 1 定义为完全缓解。采用 Pearson χ2 检验评估术前影像学因素与疼痛缓解之间的关系,并进行多因素 logistic 回归分析。

结果

45.5%的患者获得完全缓解。3 个月时,骨折椎体(FVB)内裂隙大于 FVB 高度的一半是完全缓解组的显著关键因素。此外,FVB 的椎管内骨碎片占据≥40%与不完全缓解相关。

结论

大的椎体内裂隙是 PVP 治疗骨质疏松性压缩性骨折患者短期预后的有利预测因素,而 FVB 严重突出导致腰椎椎管狭窄不是完全缓解的短期预后有利预测因素。

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