Department of Orthopedic Surgery, Juntendo University, Tokyo 113-8421, Japan.
Spine and Spinal Cord Center, Juntendo University Hospital, Tokyo 113-8421, Japan.
Medicina (Kaunas). 2024 Jul 4;60(7):1097. doi: 10.3390/medicina60071097.
: This study retrospectively examined whether the incidence rates of adjacent vertebral fractures (AVFs) can be reduced through balloon kyphoplasty (BKP) for osteoporotic vertebral fractures (OVFs) in the early stages, when there is little vertebral height variation. : A total of 95 patients (22 males, 73 females, mean age: 80.7 years) who had undergone BKP were divided into two groups: the Early group (underwent BKP within 2 weeks after injury, = 62), and the Non-early group (underwent BKP > 2 weeks after injury, = 33). The following data were analyzed: patient characteristics; fracture level; the presence of old vertebral fractures, posterior wall injury, and intravertebral cleft; duration of surgery; duration of hospitalization; cement volume; the occurrence of AVF; the timing of AVF occurrence; Numerical Rating Scale (NRS) scores at the preoperative, postoperative, and final follow-up assessments; posterior vertebral kyphosis angle of the affected vertebra on plain lateral X-ray; vertebral wedge ratio; local kyphotic angle; and changes in posterior vertebral kyphosis angle, vertebral wedge ratio, and local kyphotic angle between preoperative and postoperative assessments. The patients were divided based on the occurrence or non-occurrence of AVF after BKP: the Non-AVF group, in which AVF did not occur, and the AVF group, in which AVF occurred. : The incidence of AVF was 15.8% (15/95 patients), with a notably lower incidence rate in the Early group at 6.5% (4/62 patients) compared to the Non-early group at 33.3% (11/33 patients). NRS scores significantly improved in both groups at the postoperative assessment and final follow-up. The changes in posterior vertebral kyphosis angle and vertebral wedge ratio were significantly lower in the Early group. In the Non-AVF group, the time from injury to surgery was significantly shorter. : The Early group had a significantly lower incidence of AVF. The time from injury to surgery was a risk factor for AVF occurrence, suggesting that early BKP is recommended.
: 本研究回顾性分析了在骨质疏松性椎体骨折(OVF)早期,当椎体高度变化较小时,通过球囊椎体后凸成形术(BKP)是否可以降低相邻椎体骨折(AVF)的发生率。 : 共纳入 95 例患者(男 22 例,女 73 例,平均年龄 80.7 岁),其中 62 例行早期 BKP(伤后 2 周内行 BKP),33 例行非早期 BKP(伤后 2 周内行 BKP)。分析患者的一般资料、骨折节段、是否存在陈旧性骨折、后缘骨折、椎体内裂隙、手术时间、住院时间、骨水泥量、AVF 的发生情况、AVF 发生时间、术前、术后及末次随访时的疼痛视觉模拟评分(NRS)评分、伤椎正侧位 X 线片上的后凸角、椎体楔变指数、局部后凸角及术前术后的后凸角、椎体楔变指数、局部后凸角变化情况。根据术后是否发生 AVF 将患者分为非 AVF 组(未发生 AVF)和 AVF 组(发生 AVF)。 : BKP 术后 AVF 的发生率为 15.8%(15/95 例),其中早期组为 6.5%(4/62 例),显著低于非早期组的 33.3%(11/33 例)。两组术后和末次随访时的 NRS 评分均显著改善,早期组的后凸角和椎体楔变指数变化显著更小。在非 AVF 组中,手术时间与从受伤到手术的时间呈显著负相关。 : 早期组 AVF 的发生率显著更低。从受伤到手术的时间是 AVF 发生的危险因素,提示早期行 BKP 是有利的。