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骨水泥在椎体中的分布会影响老年骨质疏松性椎体压缩骨折患者经皮椎体成形术治疗后再压缩的几率。

Bone cement distribution in the vertebral body affects chances of recompression after percutaneous vertebroplasty treatment in elderly patients with osteoporotic vertebral compression fractures.

作者信息

Zhang Liang, Wang Qiang, Wang Lin, Shen Jian, Zhang Qiwei, Sun Changtai

机构信息

Department of Orthopedics, Beijing Hospital, National Center of Gerontology, People's Republic of China.

出版信息

Clin Interv Aging. 2017 Feb 22;12:431-436. doi: 10.2147/CIA.S113240. eCollection 2017.

Abstract

OBJECTIVE

Percutaneous vertebroplasty (PVP) is a surgical procedure that has been widely used to treat patients suffering from osteoporotic vertebral compression fractures (OVCFs). The procedure involves injection of bone cement into a fractured vertebra. In this study, we investigated whether the distribution of the cement in the vertebral body is related to the occurrence of recompression after surgery.

PATIENTS AND METHODS

A total of 172 patients diagnosed with OVCF, from January 2008 to June 2013, were retrospectively reviewed. Fifty of these patients experienced recompression after surgery during the follow-up period (recompression group), and 122 patients had no recompression observed during the follow-up period (control group). Statistical analysis was performed to compare clinical and operative parameters between these two groups.

RESULTS

Differences were found in bone cement distribution between the recompression group and control group (=0.001). Patients with bone cement distributed around both upper and lower endplates had a significantly less incidence of recompression (4/50 patients), when compared to other patterns of cement distribution (eg, below upper endplate, above lower endplate, and in the middle of vertebral body). The logistic multiple regression analysis also indicated that patients with bone cement distributed around both the upper and lower endplates had a lower risk of recompression when compared to patients with bone cement distributed in the middle of vertebral body (odds ratio =0.223, =0.003).

CONCLUSION

We herein suggest that the control of bone cement distribution during surgery provides beneficial effects on reducing the risks of recompression after PVP treatment in patients with OVCF.

摘要

目的

经皮椎体成形术(PVP)是一种已被广泛用于治疗骨质疏松性椎体压缩骨折(OVCF)患者的外科手术。该手术包括向骨折的椎体注射骨水泥。在本研究中,我们调查了椎体中骨水泥的分布是否与术后再压缩的发生有关。

患者和方法

回顾性分析了2008年1月至2013年6月期间共172例诊断为OVCF的患者。其中50例患者在随访期间术后出现再压缩(再压缩组),122例患者在随访期间未观察到再压缩(对照组)。进行统计分析以比较两组之间的临床和手术参数。

结果

再压缩组和对照组之间的骨水泥分布存在差异(P=0.001)。与其他骨水泥分布模式(例如,上终板下方、下终板上方和椎体中部)相比,骨水泥分布在上、下终板周围的患者再压缩发生率显著较低(4/50例患者)。逻辑多元回归分析还表明,与骨水泥分布在椎体中部的患者相比,骨水泥分布在上、下终板周围的患者再压缩风险较低(优势比=0.223,P=0.003)。

结论

我们在此表明,手术期间控制骨水泥分布对降低OVCF患者PVP治疗后再压缩风险具有有益作用。

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