数字技术在椎体成形术中分析骨水泥最优体积分数百分比及分布的影响因素。

Analysis of optimal volume fraction percentage and influencing factors of bone cement distribution in vertebroplasty using digital techniques.

机构信息

Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, 32 Meijian Road, Xuzhou, 221000, Jiangsu, China.

Graduate School of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China.

出版信息

J Orthop Surg Res. 2023 Mar 23;18(1):235. doi: 10.1186/s13018-023-03719-3.

PURPOSE

To explore the optimal volume fraction percentage (VF%) and influencing factors of bone cement distribution in percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCF) using digital techniques.

PATIENTS AND METHODS

From January 2019 to February 2021, 150 patients with 0VCF who underwent PVP surgery in our hospital were analyzed. Based on postoperative X-ray and CT, the spatial distribution score of the intravertebral cement was calculated and the patients were divided into two groups: 0-7 were divided into group A; 8-10 were divided into group B. The general data of the two groups of patients were compared, and Mimics three-dimensional reconstruction images were used to measure the cement dispersion volume (CDV), vertebral body volume (VBV), and VF%. Factors affecting bone cement distribution were included in a multifactorial logistic regression analysis to construct a receiver operating characteristic (ROC) curve, calculate a cut-off value for the extensive distribution of bone cement, and analyze the correlation between bone cement distribution scores and VF%.

RESULTS

There were 60 patients in group A and 90 patients in group B. Univariate analysis showed that bone mineral density (BMD), cement leakage, CDV, and VF% were significantly lower in group A than in group B (p < 0.05). Multivariate logistic regression analysis showed that BMD and VF% were independent influencing factors on bone cement distribution. The area under the curve (AUC) of VF% was 84.7%, and the cut-off value for extensive distribution of bone cement was 28.58%, which corresponded to a sensitivity and specificity of 72.2% and 91.7%, respectively. There was a strong correlation between the cement distribution score and VF% (r = 0.895, p < 0.001).

CONCLUSION

BMD and VF% were important independent influencing factors of bone cement distribution. Extensive bone cement distribution can be achieved when the VF% reaches 28.58%.

目的

利用数字技术探讨经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩性骨折（OVCF）时骨水泥最佳体积分数（VF%）及分布的影响因素。

方法

回顾性分析 2019 年 1 月至 2021 年 2 月我院收治的 150 例行 PVP 手术的 OVCF 患者，依据术后 X 线及 CT 计算椎体内骨水泥的空间分布评分，将患者分为两组：0-7 分者为 A 组，8-10 分者为 B 组。对比两组患者一般资料，采用 Mimics 三维重建图像分别测量骨水泥弥散体积（CDV）、椎体体积（VBV）、VF%，并将影响骨水泥分布的因素纳入多因素 Logistic 回归分析，构建受试者工作特征（ROC）曲线，计算骨水泥广泛分布的截断值，分析骨水泥分布评分与 VF%的相关性。

结果

A 组 60 例，B 组 90 例。单因素分析显示，A 组患者骨密度（BMD）、骨水泥渗漏、CDV、VF%均显著低于 B 组（p < 0.05）。多因素 Logistic 回归分析显示，BMD、VF%是影响骨水泥分布的独立因素。VF%的曲线下面积（AUC）为 84.7%，骨水泥广泛分布的截断值为 28.58%，此时敏感度、特异度分别为 72.2%、91.7%。骨水泥分布评分与 VF%间具有较强相关性（r = 0.895，p < 0.001）。