PVP和PKP治疗骨质疏松性椎体骨折后伤椎塌陷在冠状位上的影像学改变  

Imaging changes of injured vertebrae collapse in coronal plane after PVP and PKP treatment for treating osteoporotic vertebral fractures

作　　者：刘列华 王建刚 王晓嘉 吕应文 任周奎 于金华 刘旭 周强[4] LIU Liehua;WANG Jiangan;WANG Xiaojia;LYU Yingwen;REN Zhoukui;YU Jinhua;LIU Xu;Zhou Qiang(Department of Orthopedics Chongqing Municipal Thirteen People′s Hospital,Chongqing 400053,China;Department of Radiology,Chongqing Municipal Thirteen People′s Hospital,Chongqing 400053,China;Orthopedics Center of PLA/Department of Orthopedics,Southwest Hospital,Third Military Medical University,Chongqing 400038,China;Ningxia Medical University,Yinchuan,Ningxia 750003,China)

机构地区：[1]重庆市第十三人民医院骨科,400053 [2]宁夏医科大学,银川750003 [3]重庆市第十三人民医院放射科,400053 [4]重庆市第十三人民医院第三军医大学西南医院骨科/全军矫形外科中心,重庆400038

出　　处：《检验医学与临床》2018年第6期740-743,共4页Laboratory Medicine and Clinic

基　　金：重庆市卫生和计划生育委员会医学科研面上项目(2016MSXM084)

摘　　要：目的观测椎体成形术(PVP)和椎体后凸成形术(PKP)治疗骨质疏松性椎体骨折后伤椎塌陷在冠状位上的影像学改变。方法回顾性分析在重庆市第十三人民医院行PVP或PKP的患者,观测术前、术后3d、末次随访时伤椎侧凸Cobb角、伤椎楔变角、伤椎两侧椎体高度及伤椎棘突与上位椎体棘突之间的距离(以下称棘突间距)以及视觉模拟(VAS)评分。结果伤椎冠状位影像参数术前与术后3d比较,术后3d与末次随访时比较,差异均无统计学意义(P>0.05)。末次随访时各参数均有不同程度丢失。术前、术后3d、末次随访时VAS评分分别为(6.91±0.73)、(2.61±0.50)、(2.26±0.62)分。末次随访时有21例患者进行了骨密度检查,平均T值-4.76±1.12。结论 PVP和PKP术后伤椎塌陷在冠状位上有相应的影像学改变,医生应重视伤椎塌陷的冠状位畸形,术后强调抗骨质疏松治疗。Objective To observe the imaging changes of the injured vertebrae collapse in the coronal plane after percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)for treating osteoporotic vertebral fractures.Methods The patients with osteoporotic vertebral fractures treated with PVP or PKP in the Chongqing Municipal Thirteen People′s Hospital were retrospectively analyzed for observing the scoliosis Cobb angle in the injured vertebrae,wedge angle of the injured vertebrae,height of the vertebrae on both sides and the distance between the upper and injured vertebral spinous processes before surgery,on postoperative 3 d and at the last follow-up.Results The injured vertebral parameters in the coronal plane had no statistically significantly differences between before surgery and on postoperative 3 d,and between on postoperative 3 d and at the last follow-up(P>0.05).At the last follow-up,various parameters had different degrees of loss.The VAS scores before surgery,on postoperative 3 d and at the last follow-up were(6.91±0.73),(2.61±0.50)and(2.26±0.62)points respectively.Twenty-one cases underwent the bone mineral density(BMD)detection at the last follow-up,with an average T value of-4.76±1.12.Conclusion The injured vertebrae collapse after PVP and PKP for treating osteoporotic vertebral fractures has corresponding imaging changes in the coronal plane.The doctor should pay attention to the injured vertebrae deformity in the coronal plane,and anti-osteoporosis treatment should be emphasized postoperatively.

关 键 词：椎体成形术 椎体后凸成形术 骨质疏松性椎体骨折 影像学改变 冠状位 

分 类 号：R445.4[医药卫生—影像医学与核医学]