经皮椎体后凸成形术对邻近椎间盘退行性变的相关性分析  

Correlation analysis of percutaneous kyphoplasty to adjacent intervertebral disc degeneration

作　　者：王国松[1] 陈建德[2] 蔡剡军[1] WANG Guosong;CHEN Jiande;CAI Shanjun(Department of Radiology, Shaoxing Hospital of Chinese Medicine, Shaoxing 312000, P.R.China;Department of Orthopedics, Shaoxing Hospital of Chinese Medicine, Shaoxing 312000, P.R.China)

机构地区：[1]浙江省绍兴市中医院放射科,浙江绍兴312000 [2]浙江省绍兴市中医院骨科,浙江绍兴312000

出　　处：《医学影像学杂志》2021年第4期671-674,共4页Journal of Medical Imaging

基　　金：浙江省绍兴市科技局科技计划项目(编号:2018C30125)。

摘　　要：目的探讨胸腰段椎体新近压缩性骨折经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)后加剧相邻椎间盘退行性变的机制,比较术后不同时间椎间盘退行性变程度间的差异。方法选取胸腰段新近压缩骨折患者PKP术65例患者临床资料,于术前后均有磁共振成像检查资料,分成术后随访时间≤12个月和>12个月两组,利用磁共振(FS-T2WI矢状位)图像进行Pfirrmann分级,分别记录两组患者手术前后压缩骨折椎体(术椎)上、下两个椎间盘与非骨折椎体(非术椎)下单个椎间盘在FS-T2WI的磁共振Pfirrmann等级,对比手术前后同一患者同一椎间盘的Pfirrmann等级变化,最后采用统计学的方法进行对比分析,并进行相关机制分析。结果65例患者中,男性11例,女性54例,年龄60~90岁。评估手术椎上、下椎间盘和非手术椎下椎间盘各65个,随访时间≤12个月组的术前后Pfirrmann分级对比结果差异无统计学意义(P>0.05),随访时间>12个月组术前后Pfirrmann分级对比结果表明差异有统计学意义(P<0.05)。结论椎体PKP手术后加剧邻近椎间盘退行性变机制较多,但对加速邻近椎间盘退行性变程度在术后时间长短上有区别,术后≤12个月没有明显加剧作用,对术后12个月后邻近椎间盘具有加剧退变作用。Objective To analyze the mechanism of the adjacent intervertebral disc degeneration after percutaneous kyphoplasty(PKP)for newly compressed thoracolumbar vertebral fracture,and to compare the degree of intervertebral disc degeneration at different time after operation.Methods Retrospective analysis was performed during January 2018 to December 2020,PKP was performed in 65 patients with newly compressed thoracolumbar frature.There were magnetic resonance imaging examination data before and after the operation.The Pfirrmann grades of magnetic resonance imaging(MRI)on T2WI was recorded for the upper and lower intervertebral discs of the compressed fractured vertebra(operative)and the single intervertebral disc of the non-fractured vertebra(non-operative)before and after surgery in the two groups.Finally,statistical method was used for comparative research and related mechanism analysis.Results Among the 65 selected patients,11 were male and 54 were female,aged 60~90 years old.Sixty-five intervertebral discs were assessed in each upper and lower the operative vertebrae,and sixty-five intervertebral discs were assessed in the non-operative paravertebral vertebrae.The results of the pfirrmann classification before and after the operation in the group with a follow-up time of≤12 months were not statistical significance(P>0.05).Follow-up time>12-month group Pfirrmann classification results before and after surgery showed that the difference was statistically significant(P<0.05).Conclusion There are many mechanisms that aggravate adjacent intervertebral disc degeneration after PKP holded after the operation.However,there is a difference in the postoperative length of time to accelerate the degree of adjacent disc degeneration,for≤12 months after operation,there is no obvious acceleration effect,and it has a significant effect on adjacent disc degeneration after 12 months.

关 键 词：椎间盘退行性变 经皮椎体后凸成形术 Pfirrmann分级 磁共振成像 

分 类 号：R445.1[医药卫生—影像医学与核医学] R681.5[医药卫生—诊断学]