Department of Orthopaedic, The First Hospital Of Ningbo University, No. 247, Renmin Road, Jiangbei District, Ningbo, Zhejiang, People's Republic of China.
Institute of Orthopaedics, Ningbo University, No. 247, Renmin Road, Jiangbei District, Ningbo, Zhejiang, People's Republic of China.
BMC Musculoskelet Disord. 2023 Jun 9;24(1):473. doi: 10.1186/s12891-023-06575-8.
Percutaneous vertebroplasty(PVP) has been widely used in treating symptomatic Schmorl's nodes(SNs). However, there were still some patients with poor pain relief. At present, there is a lack of research to analyze the reasons for poor efficacy.
Review the SNs patients treated with PVP in our hospital from November 2019 to June 2022, collect their baseline data. Reverse reconstruction software was used to calculate the filling rate of bone edema ring(R). NRS score was used to evaluate pain and ODI to evaluate function. The patients were divided into remission group(RG) and non remission group(n-RG) according to symptom. In addition, according to the R, they were divided into excellent, good and poor groups. Differences between groups were investigated.
A total of 26 vertebrae were included in 24 patients. When grouped according to symptoms, patients in n-RG were older, and surgical segments were tend to locate in lower lumbar spine. The proportion of Poor distribution was significantly higher. When grouped according to the cement distribution, the preoperative NRS and ODI of the three groups were comparable, but the NRS and ODI of Poor group were significantly worse than the Excellent and Good groups postoperatively and at the last follow-up.
The cement distribution may significantly affect the efficacy of PVP in treating symptomatic SNs. We suggest that the bone edema ring should be filled as fully as possible to ensure the efficacy. In addition, advanced age and low lumbar lesions are also adverse factors for clinical outcomes.
经皮椎体成形术（PVP）已广泛用于治疗有症状的许莫氏结节（SNs）。然而，仍有一些患者疼痛缓解不佳。目前，缺乏分析疗效不佳原因的研究。
回顾 2019 年 11 月至 2022 年 6 月在我院接受 PVP 治疗的 SNs 患者，收集其基线数据。使用反向重建软件计算骨水肿环（R）的填充率。使用 NRS 评分评估疼痛，使用 ODI 评估功能。根据症状将患者分为缓解组（RG）和未缓解组（n-RG）。此外，根据 R 值将患者分为优秀、良好和较差组，比较组间差异。
共纳入 24 例患者的 26 个椎体。根据症状分组时，n-RG 患者年龄较大，手术节段倾向于位于下腰椎。差分布的比例明显更高。根据水泥分布分组时，三组的术前 NRS 和 ODI 相似，但差组的 NRS 和 ODI 在术后和末次随访时明显差于优组和良组。
水泥分布可能显著影响 PVP 治疗有症状 SNs 的疗效。我们建议尽可能充分填充骨水肿环以确保疗效。此外，高龄和低位腰椎病变也是临床结局的不利因素。
