MRI STIR黑线信号与骨质疏松椎体压缩骨折PKP术疗效的相关性  

Correlation Between MRI STIR Black Line Signal and PKP for Osteoporotic Vertebral Compression Fractures

作　　者：杨洋 冯俊飞 周青松 赵强[2] 刘凯鑫 何江涛[2] Yang Yang;Feng Junfei;Zhou Qingsong(Department of Orthopaedics,Yubei District People′s Hospital,Chongqing 401120;Department of orthopaedics,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,China)

机构地区：[1]重庆市渝北区人民医院骨一科,重庆401120 [2]川北医学院附属医院骨科,四川南充637000

出　　处：《四川医学》2023年第5期523-528,共6页Sichuan Medical Journal

摘　　要：目的探讨术前MRI STIR黑色线性信号的出现是否影响骨质疏松椎体压缩性骨折(OVCF)患者行经皮椎体后凸成形术(PKP)的疗效。方法回顾性分析2017年8月1日至2021年6月1日在我院住院并接受PKP手术治疗的OVCF患者80例,所有患者入院后均行X线片、QCT、MRI检查。根据MRI STIR上信号的不同表现分为两组:黑色线性信号组(A组)和非黑色线性信号组(B组),其中A组32例,B组48例。比较两组患者术前一般资料、手术前后VAS、ODI评分、Cobb角变化以评估疗效。结果两组患者共发现新鲜骨折椎体85例,结合患者临床和影像学表现最终确认责任椎体85例。首先比较两组患者年龄、性别、骨密度值未见显著性差异(P>0.05)。两组患者基线资料相似,对比两组患者术后VAS评分、ODI评分和Cobb角都较术前明显改善(P<0.05),但两组患者术后VAS和ODI评分揭示A组手术疗效较B组差,差异有统计学意义(P<0.05)。术后随访中Cobb角的改变上两组患者之间差异无统计学意义(P>0.05)。结论术前MRI STIR黑色线信号的出现预示着需要手术的干预,但PKP术对伴黑线信号表现的OVCF患者疼痛缓解程度不佳。Objective To investigate whether the presence of a black line signal on preoperative MRI STIR affects the outcome of percutaneous kyphoplasty in patients with osteoporotic vertebral compression fracture(OVCF).Methods A retrospective analysis of 80 cases of OVCF patients hospitalized in our hospital and receiving PKP surgery from August 1,2017 to June 1,2021 was performed.All the patients underwent X-ray,QCT and MRI examination after admission.According to the different manifestations of signals on the MRI STIR,they were divided into two groups:black line signal group(group A)and non-black line signal group(group B),with 32 cases in group A and 48 cases in group B.The general information before operation,VAS,ODI score and Cobb angle change before and after operation were compared between the two groups to evaluate the curative effect.Results A total of 85 fresh fractured vertebral bodies were found in the two groups,and 85 responsible vertebral bodies were finally confirmed based on the clinical and imaging manifestations of patients.There was no significant difference in age,gender and bone mineral density between the two groups(P>0.05).The baseline data of patients in the two groups were similar.The postoperative VAS score,ODI score and Cobb angle of patients in the two groups were significantly improved compared with those before surgery(P<0.05).However,the postoperative VAS and ODI scores of patients in the two groups revealed that the surgical efficacy in group A was worse than that in group B,and the difference was statistically significant(P<0.05).There was no significant difference in Cobb angle changes between the two groups at the postoperative follow-up and the results were not statistically significant(P>0.05).Conclusion The presence of preoperative MRI STIR black line signal predicts the necessity for surgical intervention,but PKP surgery provides poor pain relief in patients with OVCF with black line signal presentation.

关 键 词：骨质疏松 椎体压缩骨折 经皮椎体后凸成形术 核磁共振 黑色线性信号 

分 类 号：R687.3[医药卫生—骨科学]