| 单侧椎体成形术骨水泥分布的影像定量分析与疗效相关性研究 |
| Quantitative radiographic analysis of bone cement distribution patterns in unilateral vertebroplasty: Correlation with therapeutic efficacy |
| 投稿时间：2025-05-19 |
| DOI：10.3969/j.issn.1672-5972.2026.01.005 |
| 中文关键词: 骨质疏松性椎体压缩骨折 经皮椎体成形术 骨水泥分布 影像定量分析 |
| 英文关键词:Osteoporotic vertebral compression fracture Percutaneous vertebroplasty Bone cement distribution Quantitative radiographic analysis |
| 基金项目: |
|
| 摘要点击次数: 15 |
| 全文下载次数: 1 |
| 中文摘要: |
| 目的 探讨基于影像定量分析的单侧椎体成形术中骨水泥分布模式与临床疗效的关联性。方法 回顾性分析2019年1月至2023年8月在新疆医科大学第五附属医院行单侧经皮椎体成形治疗的159例患者。根据术后X线片，将侧位骨水泥分布根据骨水泥－终板接触情况分为3型：Ⅰ组，未接触型（骨水泥不接触上下终板）；Ⅱ组，单侧接触型（骨水泥只接触上终板或只接触下终板）；Ⅲ组，双侧接触型（骨水泥同时接触上下终板）。对比三组患者的基本资料，相关指标包括手术时间、术后住院时间、骨水泥注射量、VAS评分及ODI评分、术后椎体高度恢复率、椎体局部后凸Cobb角、损伤椎体及邻近椎体再骨折发生率等，记录所有患者的随访结果。结果 所有患者均顺利完成手术。所有患者随访13～18个月，平均（15.5±1.44）个月。Ⅲ组患者术后1年腰痛VAS评分及ODI明显低于Ⅰ组和Ⅱ组，差异有统计学意义（P＜0.05）；Ⅰ组和Ⅱ组损伤椎体再次骨折发生率高于Ⅲ组，差异有统计学意义（P＜0.05）；三组的手术时间，术后住院时间，术后1周、1个月的腰痛VAS评分及ODI评分、椎体局部后凸Cobb角、术后椎体高度、骨水泥渗漏等指标比较，差异无统计学意义（P＞0.05）。结论 与骨水泥不接触上下终板组和骨水泥只接触上终板或只接触下终板组相比，骨水泥同时接触上下终板组患者可获得更好的长期预后，而且骨水泥同时接触上下终板能够明显降低损伤椎体及总椎体骨折发生率，医生术中应充分掌握骨水泥的弥散情况，并制定有针对性的预防和治疗策略，从而有助于减少未来再发生骨折的风险。 |
| 英文摘要: |
| Objective To investigate the correlation between bone cement distribution patterns and clinical outcomes in unilateral vertebroplasty using quantitative radiographic analysis.Methods A retrospective study included patients undergoing unilateral percutaneous vertebroplasty at the Fifth Affiliated Hospital of Xinjiang Medical University (from January 2019 to August 2023). Postoperative lateral radiographs classified cement distribution into three types based on endplate contact: Type Ⅰ (non-contact: no cement touching the upper/lower endplates), Type Ⅱ (unilateral contact: cement touching either the upper or lower endplate), and Type Ⅲ (bilateral contact: cement touching both endplates). Demographic data and clinical parameters were compared, including operative time, postoperative hospitalization, cement volume, visual analog scale (VAS) for back pain, Oswestry disability index (ODI), vertebral height restoration rate, local kyphotic angle, and incidence of index/adjacent vertebral fractures.Results All patients successfully completed the surgery. The VAS scores for low back pain and ODI at 1 year postoperatively in Group Ⅲ were significantly lower than those in Groups Ⅰ and Ⅱ, with statistical significance (P<0.05). The incidences of refracture at the injured vertebra and total vertebral fractures in Groups Ⅰ and Ⅱ were higher than those in Group Ⅲ, and all differences were statistically significant (P<0.05). For the remaining parameters among the three groups, including cement leakage, VAS scores for low back pain and ODI scores at 1 week and 1 month postoperatively, postoperative vertebral height restoration rate, local vertebral kyphotic angle, operation duration, and postoperative hospital stay, no significant differences were observed (P>0.05).Conclusion Patients in whom the cement contacts both the superior and inferior endplates demonstrate significantly better long-term outcomes compared to those with cement contacting neither endplate or only one endplate. Furthermore, achieving cement contact with both endplates is associated with a significantly reduced incidence of subsequent fractures both within the cement-augmented vertebra and in the total spine. Care should be taken intraoperatively to ensure adequate cement distribution and to formulate targeted preventive strategies. This approach is crucial for mitigating the risk of future fractures. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
