骨扫描确定多发骨质疏松椎体压缩性骨折责任椎  

Bone scan identifying responsible vertebrae of percutaneous vertebroplasty for multiple osteoporotic vertebral compression fractures

作　　者：孙璇 朱海 季峰[1] 王守国[1] SUN Xuan;ZHU Hai;JI Feng;WANG Shou-guo(The First People's Hospital of Huaian City,Nanjing Medical University,Huaian 223300,China)

机构地区：[1]南京医科大学附属淮安第一医院,江苏淮安223300

出　　处：《中国矫形外科杂志》2024年第3期271-274,共4页Orthopedic Journal of China

摘　　要：[目的]评价骨扫描在诊断多发骨质疏松椎体压缩性骨折(multiple osteoporotic vertebral compression fractures,MOVCFs)有磁共振(MRI)禁忌的患者中确定责任椎的应用价值。[方法]回顾性研究2013年1月—2022年6月在本院诊治的14例MOVCFs患者。所有患者均接受X线、CT和骨扫描成像检查,依据骨扫描成像确定责任椎,行椎体成形术(percutaneous vertebroplasty,PVP),评估临床效果。[结果]X线及CT显示14例患者共有32个椎体压缩性骨折。骨扫描显示有1例椎体核素摄取正常;另外13例患者中X线及CT所见共有30个椎体楔形变,但只有17个楔形变椎体在骨扫描成像中显示出摄取浓聚,骨扫描成像检出阳性率53.1%。认定为责任椎。13例患者接受PVP,其中,9例为单节段,4例为双节段。所有患者均顺利完成手术,无并发症。与术前相比,患者术后1 d和末次随访时VAS[(7.9±2.4),(3.6±1.8),(4.1±1.2),P<0.001]和ODI[(42.4±6.8),(12.5±3.1),(14.7±2.9),P<0.001]评分均显著下降。[结论]对于有MRI禁忌证的多发骨质疏松椎体压缩性骨折的患者,骨扫描成像是定位责任椎的有效方法。[Objective]To evaluate the value of bone scan in determining responsible vertebral fractures of percutaneous vertebroplasty in patients who were contraindicated to magnetic resonance imaging(MRI)in the diagnosis of multiple osteoporotic compression fractures(MOVCFs).[Methods]A retrospective study was performed on 14 patients who were treated for MOVCFs in our hospital from January 2013to June 2022.All patients received X-ray,CT and bone scan examinations.The responsible vertebrae were determined based on bone scan and followed by percutaneous vertebroplasty(PVP)performed.The clinical outcome was evaluated.[Results]X-ray and CT showed a total of 32 vertebral compression fractures in 14 patients.However,bone scan showed that one of them had normal vertebral nuclide uptake,whereas the other 13 patients who had a total of 30 vertebral wedges change seen by X-ray and CT,had only 17 wedged vertebrae with uptake concentration on bone scan imaging,with a positive rate of 53.1%on bone scan imaging.As identified as responsible vertebrae,the 13patients received PVP,including single segment in 9 cases and double segments in 4 cases.All patients had PVP performed successfully without complications.Compared with those preoperatively,VAS[(7.9±2.4),(3.6±1.8),(4.1±1.2),P<0.001]and ODI[(42.4±6.8),(12.5±3.1),(14.7±2.9),P<0.001]scores decreased significantly 1 day postoperatively and at the latest follow up.[Conclusion]Bone scan is an effective method to locate the responsible vertebrae in patients with multiple osteoporotic vertebral compression fractures if MRI is contraindicated.

关 键 词：多发骨质疏松椎体压缩性骨折 骨扫描成像 椎体成形术 

分 类 号：R683.2[医药卫生—骨科学]