Ni Wen-fei, Xu Hua-zi, Chi Yong-long, Lin Yan, Huang Qi-shan, Mao Fang-min, Wang Xiang-yang, Wang Sheng, Xu Hui
Department of Orthopaedic Surgery, the Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China.
Zhonghua Wai Ke Za Zhi. 2012 Mar;50(3):251-5.
To study incidence and radiological features of intravertebral cleft (IVC) in patients with chronic pain due to osteoporotic vertebral compression fractures (OVCFs), and analyze influence of IVC for surgery of percutaneous kyphoplasty (PKP).
Seventy-six patients with osteoporotic vertebral compression fractures and pain duration more than one month were underwent procedures of PKP between August 2005 and August 2010. The incidence and radiological features of IVC were analyzed. Sixty-one patients with single-level OVCFs were divided into two groups with and without IVC. Preoperative and postoperative kyphotic angle and relative anterior vertebral height were recorded, as well as visual analogue scales (VAS) and Oswestry disability index (ODI). Cement patterns of opacification and leakage were also recorded.
Thirty two patients with 39 vertebrates were found with IVC sign. The diagnostic sensitivity of X ray, CT and MRI for IVC was respectively 33.3%, 85.7% and 84.6%. Two groups with IVC and without IVC both had apparent correction of kyphotic angle and reduction of anterior height at 3 days after surgery and last follow-up (F = 21.82 - 72.18, P < 0.01). There was no statistical significance between two groups (P > 0.05). In addition, both groups had significant improvement as regard to VAS and ODI (F = 131.06 - 364.12, P < 0.01). Solid pattern accounted for 72.0% of all cemented vertebrates in the group with IVC and 19.4% in the group without IVC. Four cement leakage were found in the group with IVC and another four in the group without IVC.
There is a high incidence of IVC in patients with chronic pain due to osteoporotic vertebral compression fractures. CT and MRI are sensitive for detection of IVC. The procedure of PKP is effective for both groups with and without IVC. IVC produces an apparent influence on cement opacification and leakage location during the procedure of PKP.
研究骨质疏松性椎体压缩骨折（OVCFs）所致慢性疼痛患者椎体内裂隙（IVC）的发生率及影像学特征，并分析IVC对经皮椎体后凸成形术（PKP）手术的影响。
2005年8月至2010年8月期间，76例骨质疏松性椎体压缩骨折且疼痛持续时间超过1个月的患者接受了PKP手术。分析IVC的发生率及影像学特征。61例单节段OVCFs患者被分为有IVC和无IVC两组。记录术前和术后的后凸角、相对椎体前缘高度，以及视觉模拟评分（VAS）和Oswestry功能障碍指数（ODI）。还记录了骨水泥的填充模式和渗漏情况。
32例患者的39个椎体发现有IVC征象。X线、CT和MRI对IVC的诊断敏感性分别为33.3%、85.7%和84.6%。有IVC和无IVC两组在术后3天及末次随访时后凸角均有明显矫正，椎体前缘高度均有恢复（F = 21.82 - 72.18，P < 0.01）。两组间差异无统计学意义（P > 0.05）。此外，两组在VAS和ODI方面均有显著改善（F = 131.06 - 364.12，P < 0.01）。在有IVC组中，骨水泥呈实心型的椎体占所有注入骨水泥椎体的72.0%，在无IVC组中占19.4%。有IVC组发现4例骨水泥渗漏，无IVC组也发现4例骨水泥渗漏。
骨质疏松性椎体压缩骨折所致慢性疼痛患者中IVC的发生率较高。CT和MRI对IVC的检测敏感。PKP手术对有IVC和无IVC两组均有效。IVC在PKP手术过程中对骨水泥填充及渗漏部位有明显影响。
