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骨扫描成像在确定有 MRI 禁忌证的骨质疏松性椎体压缩骨折患者疼痛椎体中的价值。

Value of bone scan imaging in determining painful vertebrae of osteoporotic vertebral compression fractures patients with contraindications to MRI.

机构信息

Department of Orthopaedic Surgery, First Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

Orthop Surg. 2012 Aug;4(3):172-6. doi: 10.1111/j.1757-7861.2012.00187.x.

Abstract

OBJECTIVE

To assess the value of bone scan imaging in determining painful vertebrae of osteoporotic vertebral compression fractures (OVCFs) patients with contraindications to MRI.

METHODS

Twenty-three OVCFs patients with contraindications to MRI, diagnosed and treated in our hospital between December 2007 and November 2010, were enrolled in this retrospective study. There were 18 females and five males, aged from 57 to 87 years, with a mean age of 69.5 years. All patients underwent X-ray, CT scans examinations and bone scan to determine painful vertebrae. After the painful vertebra was defined, percutaneous kyphoplasty (PKP) was performed. Efficacy of PKP was assessed with visual analog (VAS) pain scale and the Oswestry Disability Index (ODI) preoperatively, postoperatively and during final follow-up assessments.

RESULTS

The painful vertebrae shown on radiological films did not accord with those found based on bone scan imaging, with a high rate of incongruent findings (27.3%, 9/33). Radiological films showed 33 vertebrae with fractures, but only 26 vertebrae (22 patients) were selected as painful vertebrae for PKP based on bone scan imaging. There were statistically significant differences in mean VAS and ODI between the preoperative and the postoperative assessments; no significant differences were observed between postoperative and final follow-up assessments.

CONCLUSIONS

For the OVCFs patients with contraindications to MRI, bone scan imaging could be used to determine painful vertebrae, which is an effective method.

摘要

目的

评估骨扫描成像在确定有 MRI 禁忌的骨质疏松性椎体压缩性骨折(OVCF)患者疼痛椎体中的价值。

方法

回顾性分析 2007 年 12 月至 2010 年 11 月我院收治的 23 例有 MRI 禁忌证的 OVCF 患者,其中男 5 例,女 18 例;年龄 57~87 岁,平均 69.5 岁。所有患者均行 X 线、CT 扫描及骨扫描检查以确定疼痛椎体。确定疼痛椎体后,行经皮椎体后凸成形术(PKP)。术前、术后及末次随访时采用视觉模拟评分(VAS)和 Oswestry 功能障碍指数(ODI)评估 PKP 疗效。

结果

X 线片上显示的疼痛椎体与骨扫描影像学不一致,两者结果差异较大(27.3%,9/33)。X 线片显示 33 个椎体骨折,但根据骨扫描影像学仅选择 26 个椎体(22 例)作为 PKP 的疼痛椎体。术前与术后 VAS 和 ODI 评分差异均有统计学意义(P<0.05),术后与末次随访时 VAS 和 ODI 评分差异均无统计学意义(P>0.05)。

结论

对于有 MRI 禁忌证的 OVCF 患者,骨扫描成像可用于确定疼痛椎体,是一种有效的方法。

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