Department of Spine Surgery, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping St., Luzhou, 646000 Sichuan, China.
Department of Library, Southwest Medical University, No. 1 Xianglin Road of Longma District, Luzhou, 646000 Sichuan, China.
Biomed Res Int. 2020 Apr 9;2020:8593516. doi: 10.1155/2020/8593516. eCollection 2020.
The occurrence of new vertebral compression fractures (VCFs) is a common complication after percutaneous kyphoplasty (PKP). Secondary VCFs after PKP occur predominantly in the thoracolumbar segment (T11 to L2). Prophylactic injections of cement into vertebral bodies in order to reduce new VCFs have rarely been reported. The main purpose of this study was to investigate whether prophylactically injecting cement into a nonfractured vertebral body at the thoracolumbar level (T11-L2) could reduce the occurrence of new VCFs.
From July 2011 to July 2018, PKP was performed in 86 consecutive patients with osteoporotic vertebral compression fractures (OVCFs) in the thoracolumbar region (T11-L2). All patients selected underwent PKP because of existing OVCFs (nonprophylactic group). Additionally, 78 consecutive patients with fractured vertebrae in the thoracolumbar region (T11-L2) with OVCFs underwent PKP and received prophylactic injections of cement into their nonfractured vertebrae in the thoracolumbar region (T11-L2) (prophylactic group). The visual analog scale (VAS) scores and incidence of new VCFs after PKP were compared between the two groups.
The mean VAS scores improved from 8.00 ± 0.79 preoperatively to 1.62 ± 0.56 at the last follow-up in the nonprophylactic group and improved from 8.17 ± 0.84 to 1.76 ± 0.34 in the prophylactic group ( > 0.05). In the nonprophylactic group, 21 of 86 patients (24.4%) developed new VCFs within one year after PKP, of whom 15 patients (71.4%) developed VCFs within 3 months. In the prophylactic group, 8 of 78 patients (10.3%) developed new VCFs within one year, and 6 of these 8 patients (75%) developed new VCFs within 3 months. The incidence of new VCFs was significantly higher in the nonprophylactic group than that in the prophylactic group at one year ( = 0.018), but there were no statistically significant differences at three months ( = 0.847).
Prophylactic injections of cement into nonfractured (T11-L2) vertebral bodies reduced the incidence of secondary VCFs after PKP in patients with OVCFs, but there was no significant difference in local back pain (VAS) scores between the two groups.
经皮椎体后凸成形术（PKP）后新发椎体压缩性骨折（VCF）的发生是一种常见并发症。PKP 后发生的继发性 VCF 主要发生在胸腰椎段（T11 至 L2）。为了减少新的 VCF，很少有预防性地向椎体注射水泥的报道。本研究的主要目的是探讨预防性地向胸腰椎水平（T11-L2）未骨折的椎体注射水泥是否可以降低新 VCF 的发生。
2011 年 7 月至 2018 年 7 月，对 86 例胸腰椎（T11-L2）骨质疏松性椎体压缩性骨折（OVCF）患者连续行 PKP 治疗。所有选择的患者均因存在 OVCF 而行 PKP（非预防性组）。此外，对 78 例胸腰椎（T11-L2）骨折伴 OVCF 的患者行 PKP，并向胸腰椎（T11-L2）未骨折的椎体预防性注射水泥（预防性组）。比较两组患者 PKP 后视觉模拟评分（VAS）评分和新发 VCF 的发生率。
非预防性组患者的平均 VAS 评分从术前的 8.00±0.79 分改善至末次随访时的 1.62±0.56 分，预防性组患者从 8.17±0.84 分改善至 1.76±0.34 分（>0.05）。非预防性组中，21 例（24.4%）患者在 PKP 后 1 年内发生新的 VCF，其中 15 例（71.4%）患者在 3 个月内发生 VCF。预防性组中，8 例（10.3%）患者在 1 年内发生新的 VCF，其中 6 例（75%）患者在 3 个月内发生 VCF。非预防性组新发 VCF 的发生率明显高于预防性组（1 年时，=0.018），但在 3 个月时无统计学差异（=0.847）。
对 OVCF 患者 PKP 前向未骨折（T11-L2）椎体注射水泥可降低 PKP 后继发性 VCF 的发生率，但两组间局部背痛（VAS）评分无显著差异。
