Liu Hai-Xiao, Xu Cong, Shang Ping, Shen Yue, Xu Hua-Zi
Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Rehabilitation, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
J Korean Neurosurg Soc. 2014 Jun;55(6):337-42. doi: 10.3340/jkns.2014.55.6.337. Epub 2014 Jun 30.
To determine deformity correction by postural correction and subsequent balloon inflation in acute vertebral compression fractures (OVCFs) and to examine the effect of bone mineral density on deformity correction.
A totol of 50 acute OVCFs received balloon kyphoplasty. Lateral radiographs were taken and analyzed at five different time points : 1) preoperative, 2) after placing the patient in prone hyperextended position, 3) after balloon inflation, 4) after deposition of the cement, and 5) postoperative. All fractures were analyzed for height restoration of anterior (Ha), middle (Hm) and posterior (Hp) vertebra as well as Cobb angle and Kyphotic angle. The bone mineral density (BMD) of lumbar spine was measured by dual-energy X-ray absorptiometry. According to the T-score, the patients were divided into two groups which were osteoporosis group and osteopenia group.
Postoperative measurements of Ha, Hm and the Cobb angle demonstrated significant reduction of 4.62 mm, 3.66 mm and 5.34° compared with the preoperative measurements, respectively (each p<0.05). Postural correction significantly increased Ha by 5.51 mm, Hm by 4.35 mm and improved the Cobb angle by 8.32° (each p<0.05). Balloon inflation did not demonstrate a significant improvement of Ha, Hm or the Cobb angle compared with baseline prone hyperextended. Postural correction led to greater improvements of Ha, Hm and Cobb angle in osteoporosis group than osteopenia group (each p<0.05).
In acute OVCFs, the height restoration was mainly attributed to postural correction rather than deformity correction by balloon inflation. BMD affected deformity correction in the process of postural correction.
确定在急性椎体压缩骨折（OVCFs）中通过体位矫正及随后的球囊扩张实现的畸形矫正情况，并研究骨密度对畸形矫正的影响。
总共50例急性OVCFs患者接受了球囊后凸成形术。在五个不同时间点拍摄并分析侧位X线片：1）术前；2）将患者置于俯卧过伸位后；3）球囊扩张后；4）骨水泥注入后；5）术后。分析所有骨折椎体的前（Ha）、中（Hm）、后（Hp）柱高度恢复情况以及Cobb角和后凸角。采用双能X线吸收法测量腰椎骨密度。根据T值，将患者分为骨质疏松组和骨量减少组两组。
术后Ha、Hm测量值及Cobb角与术前测量值相比分别显著降低了4.62mm、3.66mm和5.34°（各p<0.05）。体位矫正使Ha显著增加5.51mm，Hm增加4.35mm，Cobb角改善8.32°（各p<0.05）。与基线俯卧过伸位相比，球囊扩张未显示Ha、Hm或Cobb角有显著改善。体位矫正导致骨质疏松组的Ha、Hm和Cobb角改善程度大于骨量减少组（各p<0.05）。
在急性OVCFs中，高度恢复主要归因于体位矫正而非球囊扩张进行的畸形矫正。骨密度在体位矫正过程中影响畸形矫正。
