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经皮椎体成形术不会增加相邻和非相邻椎体新发骨折的发生率。

Percutaneous Vertebroplasty Does Not Increase the Incidence of New Fractures in Adjacent and Nonadjacent Vertebral Bodies.

作者信息

Yang Wencheng, Yang Jianyi, Liang Ming

机构信息

The Second Department of Orthopedics, The Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou City, PR China.

出版信息

Clin Spine Surg. 2019 Mar;32(2):E99-E106. doi: 10.1097/BSD.0000000000000734.

Abstract

STUDY DESIGN

This was a clinical retrospective study.

OBJECTIVES

This retrospective study aimed to investigate the incidence of new vertebral compression fractures (NVCFs) and analyze the risk factors that influence the secondary fractures in adjacent and nonadjacent levels after percutaneous vertebroplasty (PVP) and conservative treatment (CT).

SUMMARY OF BACKGROUND DATA

PVP is an effective procedure to alleviate the pain caused by osteoporotic vertebral compression fractures. NVCFs have been noted as a potential late sequela of the procedure. However, it remains unclear whether NVCFs are due to this augmentation or simply are the result of the natural progression of osteoporosis.

METHODS

A total of 290 patients who had undergone PVP and 270 patients who had undergone CT during the last 4 years were examined. They were followed-up on a monthly basis by telephone for >2 years. They were divided into 2 groups: NVCFs and non-NVCFs. The groups were statistically compared in terms of age, sex, body mass index, initial fracture levels, bone mineral density (BMD) score of the spine, original fracture levels, and new fracture levels.

RESULTS

After a mean follow-up of at least 24 months (range, 24-78 mo), 42 NVCFs occurred in 37 of 290 patients after PVP and 33 NVCFs in 30 of 270 patients after CT. Only BMD was significantly different between the groups. Lower BMD was a significant predictive factor for NVCFs.

CONCLUSIONS

PVP did not increase the incidence of NVCFs, especially those adjacent to the treated vertebrae, following augmentation with PVP compared with CT. The most important risk factor for NVCFs was osteoporosis.

摘要

研究设计

这是一项临床回顾性研究。

目的

本回顾性研究旨在调查新鲜椎体压缩骨折(NVCF)的发生率,并分析经皮椎体成形术(PVP)和保守治疗(CT)后影响相邻和非相邻节段继发性骨折的危险因素。

背景数据总结

PVP是缓解骨质疏松性椎体压缩骨折所致疼痛的有效方法。NVCF被认为是该手术潜在的晚期后遗症。然而,NVCF是由于这种强化治疗还是仅仅是骨质疏松自然进展的结果仍不清楚。

方法

对过去4年中接受PVP的290例患者和接受CT的270例患者进行检查。通过电话每月随访他们超过2年。他们被分为两组:NVCF组和非NVCF组。对两组在年龄、性别、体重指数、初始骨折节段、脊柱骨密度(BMD)评分、原始骨折节段和新骨折节段方面进行统计学比较。

结果

平均随访至少24个月(范围24 - 78个月)后,PVP术后290例患者中的37例发生了NVCF,共42例;CT术后270例患者中的30例发生了NVCF,共33例。两组之间只有BMD有显著差异。较低的BMD是NVCF的一个重要预测因素。

结论

与CT相比,PVP强化治疗后并未增加NVCF的发生率,尤其是治疗椎体相邻节段的NVCF。NVCF最重要的危险因素是骨质疏松。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/919c/6407829/389f887d6026/bsd-32-e99-g005.jpg

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