Lee Si-Hoon, Lee Sang-Gu, Son Seong, Kim Woo-Kyung
Department of Neurosurgery, Gachon University, Gil Medical Center, Incheon, Korea.
Korean J Spine. 2014 Jun;11(2):62-7. doi: 10.14245/kjs.2014.11.2.62. Epub 2014 Jun 30.
The extent of collapse progression after vertebroplasty in osteoporotic vertebral compression fractures (OVCF) has known to be various. In this study, we investigated that how much difference of compression ratio between standing simple radiograph and supine magnetic resonance imaging (MRI) affects the collapse progression after vertebroplasty.
This retrospective cohort study was carried out based on 27 patients with 31 OVCFs undergone vertebrplastyin the thoracolumbar junction (T12-L2), from January to December 2009. The OVCFs were divided to two groups, the smaller group A and larger group B, by mean compression ratio difference (8.1%) between standing simple radiograph and supine MRI.
There were no significant differences in the baseline characteristics of the two groups except age. There were also no significant differences between the periodic compression ratio, back pain, Cobb's angle during follow-up period. However, Group B seemed to show improvements from the initial state to the point just after the operation, but eventually took a much worse course than group A. In the end, judging from the compression ratios of the two groups at the last follow up, group A showed less progression.
Although the clinical outcome was not different significantly, a greater compression ratio difference in the initial study resulted in a greater collapse progression at last follow-up. Therefore, we suggest that it is important to check the initial standing simple radiograph, as well as supine MRI, for predicting collapse progression after vertebroplasty.
已知骨质疏松性椎体压缩骨折(OVCF)椎体成形术后塌陷进展程度各不相同。在本研究中,我们调查了站立位简易X线片与仰卧位磁共振成像(MRI)之间的压缩率差异对椎体成形术后塌陷进展的影响程度。
本回顾性队列研究基于2009年1月至12月期间接受胸腰段(T12-L2)椎体成形术的27例患者的31处OVCF进行。根据站立位简易X线片与仰卧位MRI之间的平均压缩率差异(8.1%),将OVCF分为两组,较小的A组和较大的B组。
除年龄外,两组的基线特征无显著差异。随访期间的定期压缩率、背痛、Cobb角之间也无显著差异。然而,B组在从初始状态到术后即刻似乎有所改善,但最终的病程比A组差得多。最后,从末次随访时两组的压缩率判断,A组的进展较小。
虽然临床结果无显著差异,但初始研究中较大的压缩率差异导致末次随访时更大的塌陷进展。因此,我们建议,为预测椎体成形术后的塌陷进展,检查初始站立位简易X线片以及仰卧位MRI很重要。