Yang Bing-Yi, Song Shao-Kuan, Zheng Huo-Liang, Chen Qi-Zhu, Cai Hao, Wang Yong, Mardan Muradil, Jiang Lei-Sheng, Jiang Sheng-Dan
Department of Clinic of Spine Center, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
J Invest Surg. 2025 Dec;38(1):2525343. doi: 10.1080/08941939.2025.2525343. Epub 2025 Jul 13.
This review examines the diagnostic criteria, incidence rates, risk factors, preventive strategies and therapeutic approaches for post-cement augmentation vertebral recollapse, aiming to establish standardized preventive protocols.
A systematic literature search was conducted through databases such as PubMed, Web of Science, Embase, and Cochrane, identifying 78 studies meeting predefined criteria. Eligibility criteria focused on imaging outcomes and risk stratification.
The incidence of secondary vertebral recollapse after cement augmentation varies widely (8.5-63.3%) due to inconsistent diagnostic standards. Major risk factors include procedure-related (e.g., low cement volume), anatomical (e.g., thoracolumbar location), and patient-specific (e.g., low bone mineral density) factors. Effective prevention strategies encompass standardized diagnostic protocols combining radiological and clinical assessments, precise cement application techniques, and aggressive anti-osteoporosis therapy. Innovative materials, like mineralized collagen-modified bone cement, and tailored postoperative rehabilitation can further reduce recollapse rates. Management is tiered by severity: conservative treatment for minor collapses and surgical interventions for severe cases.
Vertebral recollapse is a significant post-PVA complication impacting OVCF patient prognosis. Comprehensive risk assessment, optimized cement use, and ongoing anti-osteoporosis therapy are crucial for reducing incidence. Advancements in cement formulation, technique, and standardized therapeutic frameworks are vital for improving long-term patient outcomes.
本综述探讨了骨水泥强化术后椎体再塌陷的诊断标准、发病率、危险因素、预防策略和治疗方法，旨在建立标准化的预防方案。
通过PubMed、Web of Science、Embase和Cochrane等数据库进行系统的文献检索，确定了78项符合预定义标准的研究。纳入标准侧重于影像学结果和风险分层。
由于诊断标准不一致，骨水泥强化术后继发性椎体再塌陷的发生率差异很大（8.5%-63.3%）。主要危险因素包括与手术相关的因素（如骨水泥用量少）、解剖学因素（如胸腰段位置）和患者个体因素（如低骨密度）。有效的预防策略包括结合放射学和临床评估的标准化诊断方案、精确的骨水泥应用技术以及积极的抗骨质疏松治疗。新型材料，如矿化胶原改性骨水泥，以及量身定制的术后康复可以进一步降低再塌陷率。治疗根据严重程度分层：轻度塌陷采用保守治疗，重度病例采用手术干预。
椎体再塌陷是椎体后凸成形术（PVA）后影响骨质疏松性椎体压缩骨折（OVCF）患者预后的重要并发症。全面的风险评估、优化的骨水泥使用以及持续的抗骨质疏松治疗对于降低发病率至关重要。骨水泥配方、技术和标准化治疗框架的进步对于改善患者长期预后至关重要。
