Jia Pu, Tang Hai, Chen Hao, Bao Li, Feng Fei, Yang He, Li Jinjun
Department of Orthopaedics.
Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Regen Biomater. 2017 Feb;4(1):47-53. doi: 10.1093/rb/rbw037. Epub 2016 Dec 30.
A sandwich vertebra is formed after multiple osteoporotic vertebral fractures treated by percutaneous vertebroplasty, which has a risk of developing new fractures. The purpose of our study was to (i) investigate the occurrence of new fractures in sandwich vertebra after cement augmentation procedures and to (ii) evaluate the clinical outcomes after prophylactic vertebral reinforcement applied with resorbable bone cement. From June 2011 to 2014, we analysed 55 patients with at least one sandwich vertebrae and treated with percutaneous vertebroplasty. Eighteen patients were treated by prophylactic vertebroplasty with a resorbable bone cement to strengthen the sandwich vertebrae as the prevention group. The others were the non-prevention group. All patients were examined by spinal radiographs within 1 day, 6 months, 12 months, 24 months and thereafter. The incidence of sandwich vertebra is 8.25% (55/667) in our study. Most sandwich vertebrae (69.01%, 49/71) are distributed in the thoracic-lumbar junction. There are 24 sandwich vertebrae (18 patients) and 47 sandwich vertebrae (37 patients) in either prevention group or non-prevention group, respectively. No significant difference is found between age, sex, body mass index, bone mineral density, cement disk leakage, sandwich vertebrae distribution or Cobb angle in the two groups. In the follow-up, 8 out of 37 (21.6%) patients (with eight sandwich vertebrae) developed new fractures in non-prevention' group, whereas no new fractures were detected in the prevention group. Neither Cobb angle nor vertebral compression rate showed significant change in the prevention group during the follow-up. However, in the non-prevention group, we found that Cobb angle increased and vertebral height lost significantly ( < 0.05). Prophylactic vertebroplasty procedure applied with resorbable bone cement could decrease the rate of new fractures of sandwich vertebrae.
经皮椎体成形术治疗多发性骨质疏松性椎体骨折后会形成夹心椎，其有发生新骨折的风险。我们研究的目的是：（i）调查骨水泥强化术后夹心椎新骨折的发生情况；（ii）评估应用可吸收骨水泥进行预防性椎体强化后的临床疗效。2011年6月至2014年，我们分析了55例至少有一个夹心椎且接受经皮椎体成形术治疗的患者。18例患者接受了应用可吸收骨水泥的预防性椎体成形术以强化夹心椎作为预防组。其余患者为非预防组。所有患者在术后1天、6个月、12个月、24个月及之后均接受脊柱X线检查。在我们的研究中，夹心椎的发生率为8.25%（55/667）。大多数夹心椎（69.01%，49/71）分布在胸腰段交界处。预防组和非预防组分别有24个夹心椎（18例患者）和47个夹心椎（37例患者）。两组在年龄、性别、体重指数、骨密度、骨水泥椎间盘渗漏、夹心椎分布或Cobb角方面均未发现显著差异。随访期间，非预防组37例患者中有8例（21.6%）（8个夹心椎）发生了新骨折，而预防组未检测到新骨折。随访期间预防组的Cobb角和椎体压缩率均未显示出显著变化。然而，在非预防组中，我们发现Cobb角增大且椎体高度显著丢失（<0.05）。应用可吸收骨水泥的预防性椎体成形术可降低夹心椎新骨折的发生率。
