Yu Weibo, Xiao Xiang, Zhang Jiali, Li Zhifei, Wang Xiaohu, Tang Fubo, Jiang Xiaobing, Zhong Yuanming
The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi.
Higher Vocational Technology College, Guangxi University of Chinese Medicine, Nanning, Guangxi, People's Republic of China.
World Neurosurg. 2019 Mar;123:e408-e415. doi: 10.1016/j.wneu.2018.11.181. Epub 2018 Nov 29.
To determine cement distribution patterns on therapeutic efficacy after percutaneous vertebroplasty treatment of osteoporotic vertebral compression fractures (OVCFs) with intravertebral cleft (IVC).
Patients who were treated with percutaneous vertebroplasty for single OVCFs with IVC and met this study's inclusion criteria were retrospectively reviewed. The follow-up period was at least 2 years. Distribution patterns of cement in the IVC area were respectively specified into 2 groups: group 1: solid lump distribution pattern (n = 22); group 2: the comparatively diffused pattern (n = 90). Radiologic and clinical parameters were analyzed and compared. Then, associations of recollapse with covariates and a risk score were further analyzed and developed to predict recollapse of the augmented vertebrae.
At the immediate postoperative period, all patients benefited from significant improvement in vertebrae height and kyphotic angle correction. However, significant recollapse was observed at the 2 years postoperative follow-up for the patients in group 1. Furthermore, we found that preoperative severe kyphotic deformity (a cutoff value of 12.5°), solid lump cement distribution pattern, and larger reduction angle (a cutoff value of 8.3°) was significantly associated with increased risk for recollapse. A risk score was developed based on the number of risk factors present in each patient and the receiver operating characteristic curve of the risk score generated an area under the curve of 0.788 (95% confidence interval 0.702-0.873, P = 0.000).
The comparatively diffused pattern shows better long-term radiologic and clinical outcomes for the treatment for OVCFs with IVC. A risk score can be used to predict the incidence of recollapse.
确定经皮椎体成形术治疗伴有椎体内裂隙（IVC）的骨质疏松性椎体压缩骨折（OVCFs）后骨水泥分布模式对治疗效果的影响。
回顾性分析接受经皮椎体成形术治疗单节段伴有IVC的OVCFs且符合本研究纳入标准的患者。随访期至少2年。IVC区域骨水泥分布模式分为两组：1组：实体块状分布模式（n = 22）；2组：相对弥散模式（n = 90）。分析并比较影像学和临床参数。然后，进一步分析并建立再塌陷与协变量和风险评分的关联，以预测强化椎体的再塌陷。
术后即刻，所有患者椎体高度和后凸角矫正均有显著改善。然而，1组患者在术后2年随访时观察到明显的再塌陷。此外，我们发现术前严重后凸畸形（截断值为12.5°）、实体块状骨水泥分布模式和较大的复位角度（截断值为8.3°）与再塌陷风险增加显著相关。根据每位患者存在的风险因素数量建立了一个风险评分，该风险评分的受试者工作特征曲线下面积为0.788（95%置信区间0.702 - 0.873，P = 0.000）。
相对弥散模式在治疗伴有IVC的OVCFs时显示出更好的长期影像学和临床结果。风险评分可用于预测再塌陷的发生率。
