椎体成形术后椎体高度变化的临床研究  

Study of Vetebral Body Height after Percutaneous Vertebroplasty for Osteoporotic Vetebral Compression Fractures

作　　者：刘庆文[1,2] 何仕诚[1] 滕皋军[1] 方文[1] 郭金和[1] 邓钢[1] 朱光宇[1] 李国昭[1] 

机构地区：[1]东南大学附属中大医院放射科,210009 [2]东南大学临床医学院医学影像系

出　　处：《临床放射学杂志》2009年第3期387-390,共4页Journal of Clinical Radiology

基　　金：江苏省卫生厅2005年度科技计划项目(H200539)资助

摘　　要：目的探讨骨质疏松性椎体压缩骨折经皮椎体成形术(PVP)后椎体高度是否能提高。资料与方法骨质疏松性椎体新鲜压缩骨折40例共68节,其中椎体内合并囊性裂隙12例共16节。应用64层螺旋CT在脊椎二维重组图像的正中矢状面分别测量PVP术前及术后椎体前缘、中央及后缘高度,比较PVP前后椎体高度的变化、与椎体压缩程度关系及合并囊腔裂隙者与无囊腔裂隙者的高度变化差异。结果PVP后椎体前缘、中央和后缘高度分别提高(2.01±1.72)mm、(1.78±1.47)mm及(0.44±1.03)mm;PVP术后椎体前缘、中央高度增加值与压缩程度呈正相关。椎体内合并囊变者PVP后前缘及中央高度分别提高(4.13±1.88)mm、(3.76±1.51)mm,椎体无囊变者PVP后前缘及中央高度分别提高(1.35±1.01)mm、(1.17±0.75)mm,两组比较差异有统计学意义(P<0.05);椎体有囊变者PVP术中注入骨水泥的量较无囊变者明显增加。结论PVP可提高多数骨质疏松性椎体新鲜压缩骨折的椎体高度,合并椎体囊变者的高度提高更明显;椎体高度的提高与压缩程度呈正相关。Objective To evaluate the change of vetebral height after percutaneous vertebroplasty（PVP） in treating osteoporotic compression fractures. Materials and Methods PVP was performed in 40 consecutive patients with 68 painful osteoporotic vertebral compression fractures. Among them, 16 vertebral compression fractures concurrent with intraosseous vacuum were identified in 12 patients. The anterior,central and posterior vertebral body heights were measured in the midsagittal plane of the reformatted images at 64-detector row CT before and after vertebroplasty. Results The average increase in vertebral body height was 2.01± 1.72 mm anteriorly, 1.78±1.47 mm centrally and 0.44 ± 1.03 mm posteriorly after PVP. The increase in vertebral body height was positive correlation with the original degree of vertrbral compression. After PVP, the average increase in vertebral body height was 4.13 ± 1.88 mm anteriorly,3.76 ± 1.51 mm centrally in 16 vertebral bodies with intraosseous vacuum. The average increase in vertebral body height was 1.35 ± 1.01 mm anteriorly, 1.17 ± 0. 75 mm centrally in 52 vertebral body without intraosseous vacuum. There was significantly difference （P 〈 0.05 ） in height restoration with those vertebral bodies with intraosseous vacuum and those without intraosseous vacuum. The amount of cement injection has significantly difference （ P 〈 0.05 ） between vertebral bodies with intraosseous vacuum and those without intraosseous vacuum. Conclusion Vertebral body height of osteoporotie compression fractures often increases after PVP, especially in vertebral bodies with intraosseous vacuum. The increase in vertebral body height was positive correlation with the original degree of vertrbral compression.

关 键 词：经皮椎体成形术 骨质疏松症 椎体压缩性骨折 椎体高度 

分 类 号：R687.3[医药卫生—骨科学]