预防性经皮椎体成形术可减少邻近椎体再发骨折  

Prophylactic percutaneous vertebroplasty for reduction of the refracture of adjacent vertebrae

作　　者：梅治[1] 李青[1] 赵成毅[1] 梁道臣[1] 张爱明[1] MEI Zhi;LI Qing;ZHAO Cheng-yi;LIANG Dao-cheng;ZHANG Ai-ming(Section Ⅱ ,Dept of Orthopaedics, the People′s Hosipital of Zhongshan City, Zhongshan, Guangdong 528403, China)

机构地区：[1]中山市人民医院骨二科,广东中山528403

出　　处：《临床骨科杂志》2019年第2期143-146,共4页Journal of Clinical Orthopaedics

基　　金：中山市医学科研基金项目(编号:2016J037)

摘　　要：目的探讨预防性经皮椎体成形术(PVP)是否可减少PVP术后邻近椎体再发骨折发生。方法将68例行PVP治疗的骨质疏松性椎体压缩骨折(OVCF)患者随机分为两组:A组33例,对骨折椎体行PVP; B组35例,对骨折椎体及上、下邻近椎体行PVP。术后定期行胸腰椎正、侧位X线检查,若再次出现疼痛,及时行胸腰椎MRI检查。统计PVP术后邻近椎体再发骨折的发生率。结果两组患者均随访24个月。A组随访至6个月时有12例(36. 36%)邻近椎体再发骨折;随访至12个月时,新增1例;合计有13例(39. 39%)邻近椎体再发骨折。B组随访至6个月时有2例(5. 71%)发生邻近椎体再发骨折;随访至12个月时,新增1例;合计有3例(8. 57%)发生邻近椎体再发骨折。两组随访至24个月均未见新增病例。邻近椎体再发骨折发生率B组明显少于A组,差异有统计学意义(P <0. 05)。结论预防性PVP能够减少PVP术后邻近椎体再发骨折的发生。Objective To investigate whether prophylactic percutaneous vertebroplasty(PVP) can reduce the incidence of the fractures of the adjacent vertebrae. Methods The 68 patients with osteoporotic vertebral compression fractures who underwent PVP were randomly divided into two groups.Group A(33 cases) underwent therapeutic vertebroplasty only for a vertebra with an unhealed fracture.Group B(35 cases) was injected bone cement into the adjacent vertebra and the fractured vertebra to perform the preventive PVP. The patients underwent the thoracolumbar frontal and lateral X-ray examination regularly, and if the pain occurred again,the thoracolumbar MRI examination was performed. The incidence rate of adjacent vertebrae compression fracture after PVP was counted. Results All patients in both groups were followed up for 24 months.Group A was followed up to 6 months with 12 cases (36.36%) of adjacent vertebrae with new fractures;during the follow-up to 12 months,increased 1 case,there were 13 cases (39.39%) of new fractures. Group B was followed up to 6 months with 2 cases (5.71%) of adjacent vertebrae with new fractures;during the follow-up to 12 months,increased 1 case;there were 3 cases (8.57%) of new fractures.No new cases were observed in the two groups at 24 months postoperation.The recurrence rate of adjacent vertebrae fractures was significantly lower in group B than in group A.There were significant differences in the incidence of new fractures in the two groups ( P< 0.05). Conclusions Prophylactic PVP can reduce the incidence of postoperative refracture of adjacent vertebrae after PVP.

关 键 词：骨质疏松 椎体压缩骨折 经皮椎体成形术 预防性经皮椎体成形术 再发骨折 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]