Department of Pain Management, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Orthopaedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Sci Rep. 2020 Jan 15;10(1):399. doi: 10.1038/s41598-019-57355-1.
The study aimed to analyze the radiographic and magnetic resonance imaging (MRI) findings that might predict the risk for adjacent segmental fractures (ASFs) when percutaneous vertebroplasty (PV) is used for the treatment of osteoporotic thoracolumbar fractures (OTFs). A total of 92 OTFs patients who underwent PV between January 2013 and January 2015 were retrospectively reviewed. The visual analog scale (VAS), Oswestry-Disability Index (ODI) and radiolographic measurements were assessed. The VAS and ODI scores improved significantly at the final follow-up (FU) compared with the preoperation scores. Compared with the preoperative values, the fractured body alignment (FBA) significantly improved at the 3-month FU and the final FU, but the adjacent segment alignment (ASA) and thoracolumbar alignment (TLA) did not improve. According to the correlation analysis, the final FU TLA and the final FU ASA were correlated with the preoperative FBA, ASA, and TLA on plain radiography and were highly correlated on MRI. However, the final FU FBA was not correlated with the preoperative FBA, ASA, or TLA on plain radiography or MRI (P > 0.05). The ASFs were correlated with the 3-month FU TLA (r = 0.6044, P = 0.0037) and the final FU TLA (r = 0.5699, P = 0.007) on plain radiography, and the final TLA was more correlated with the preoperative FBA, ASA, and TLA on MRI than on plain radiography. In conclusion, the preoperative ASA and TLA on MRI were risk factors associated with ASFs in OTFs treated with PV.
本研究旨在分析经皮椎体成形术（PVP）治疗骨质疏松性胸腰椎骨折（OTF）时，可能预测邻近节段骨折（ASF）风险的影像学和磁共振成像（MRI）表现。回顾性分析了 2013 年 1 月至 2015 年 1 月间接受 PVP 治疗的 92 例 OTF 患者。评估了视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）和影像学测量值。最终随访（FU）时 VAS 和 ODI 评分较术前显著改善。与术前相比，3 个月 FU 和最终 FU 时骨折体对线（FBA）显著改善，但相邻节段对线（ASA）和胸腰椎对线（TLA）无改善。相关性分析显示，最终 FU TLA 和最终 FU ASA 与术前 X 线平片上的 FBA、ASA 和 TLA 相关，与 MRI 高度相关。然而，最终 FU FBA 与术前 X 线平片或 MRI 上的 FBA、ASA 或 TLA 不相关（P>0.05）。ASF 与 X 线平片上的 3 个月 FU TLA（r=0.6044，P=0.0037）和最终 FU TLA（r=0.5699，P=0.007）相关，而最终 TLA 与 MRI 上的术前 FBA、ASA 和 TLA 相关性更高，而非 X 线平片。总之，MRI 上术前 ASA 和 TLA 是 PVP 治疗 OTF 后发生 ASF 的危险因素。
