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椎体内裂隙硬化对骨质疏松性椎体压缩骨折经皮椎体成形术疗效的影响

Impact of Intravertebral Clefts Sclerosis on Percutaneous Vertebroplasty Efficacy in Osteoporotic Vertebral Compression Fractures.

作者信息

Tang Xuebin, Zhou Chengqiang, Li Hua, Qiao Liang, Liao Yifeng, Zhang Junwei, Wang Yunqing, Xie Lin

机构信息

Department of Orthopedics, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China; Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

World Neurosurg. 2025 Feb;194:123504. doi: 10.1016/j.wneu.2024.11.087. Epub 2024 Dec 11.

Abstract

OBJECTIVE

To investigate the effect of intravertebral cleft sclerosis on the efficacy of percutaneous vertebroplasty (PVP) in osteoporotic vertebral compression fractures (OVCFs).

METHODS

We analyzed 68 OVCF patients with intravertebral clefts treated with PVP from January 2020 to June 2022. Patients were divided into 2 groups based on computed tomography findings: intravertebral clefts sclerosis (IVCs, 36 cases) and intravertebral clefts nonsclerosis (IVCns, 32 cases). Preoperative data included gender, age, bone mineral density, fractured vertebrae distribution, and disease duration. Excluding those with contraindications, all underwent PVP. Operation time, cement injection volume, leakage rate, and distribution patterns were recorded. Outcomes were evaluated using visual analog scale scores, oswestry disability index, anterior vertebral height, and Cobb angle preoperatively, and at 2 days and 1 year postoperatively.

RESULTS

The IVCs group had a longer disease duration (P < 0.05). No significant differences in operation time, cement volume, or leakage rate were observed between groups (P > 0.05). Cement distribution was mass-like in IVCs and sponge-like in IVCns (P < 0.05). Both groups showed significant improvements postoperatively (P < 0.05), but IVCns had better recovery in anterior vertebral height, Cobb angle, and oswestry disability index (P < 0.05).

CONCLUSIONS

IVCs affect cement distribution and recovery outcomes, with IVCns achieving better results. Early treatment is advised for OVCF with intravertebral clefts.

摘要

目的

探讨椎体内裂隙硬化对经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折(OVCFs)疗效的影响。

方法

我们分析了2020年1月至2022年6月期间接受PVP治疗的68例伴有椎体内裂隙的OVCF患者。根据计算机断层扫描结果将患者分为2组:椎体内裂隙硬化组(IVCs,36例)和椎体内裂隙非硬化组(IVCns,32例)。术前数据包括性别、年龄、骨密度、骨折椎体分布和病程。排除有禁忌证的患者后,所有患者均接受PVP。记录手术时间、骨水泥注入量、渗漏率和分布模式。使用视觉模拟量表评分、Oswestry功能障碍指数、椎体前缘高度和Cobb角在术前、术后2天和术后1年评估疗效。

结果

IVCs组病程较长(P < 0.05)。两组之间在手术时间、骨水泥量或渗漏率方面未观察到显著差异(P > 0.05)。IVCs组骨水泥分布呈团块状,IVCns组呈海绵状(P < 0.05)。两组术后均有显著改善(P < 0.05),但IVCns组在椎体前缘高度、Cobb角和Oswestry功能障碍指数方面恢复更好(P < 0.05)。

结论

椎体内裂隙硬化影响骨水泥分布和恢复结果,IVCns组效果更好。建议对伴有椎体内裂隙的OVCF尽早治疗。

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