Vertebroplasty for treatment of osteoporotic vertebral compression fractures with intravertebral cleft

doi:10.3969/j.issn.2095-4344.2014.13.019

Abstract

Abstract:

BACKGROUND: Clinical practice verified that percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures obtained obvious curative effects.
OBJECTIVE: To compare the therapeutic effect of percutaneous vertebroplasty for treatment for osteoporotic vertebral compression fractures with or without intravertebral cleft, in order to evaluate the efficacy and safety of percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures.
METHODS: A total of 76 patients with osteoporotic vertebral compression fractures were selected and divided into two groups. Experimental group consisted of 27 patients with intravertebral cleft. Control group comprised
49 patients without intravertebral cleft. After vertebroplasty, visual analogue scale and Oswestry disability index, changes of anterior vertebral height, and types and characteristics of bone cement leakage were compared between the two groups.
RESULTS AND CONCLUSION: Visual analogue scale and Oswestry disability index were significantly decreased after treatment in the two groups (P < 0.05). No significant differences in visual analogue scale, Oswestry disability index and incidence of bone cement leakage were detected between the two groups after treatment (P > 0.05). No significant difference in the height of injured vertebra was detectable between pretreatment and posttreatment in the two groups (P > 0.05). These results suggested that vertebroplasty is an effective method for lessening the pain in osteoporotic vertebral compression fractures in patients with or without intravertebral cleft, improving spinal activity function and elevating social activities. However, percutaneous vertebroplasty cannot effectively recover the height of the vertebra.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: biocompatible materials, vertebroplasty, osteoporosis, fractures, bone

CLC Number:

R318

Hou Zeng-tao, Chen Bo-hua . Vertebroplasty for treatment of osteoporotic vertebral compression fractures with intravertebral cleft[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(13): 2077-2082.

Figures/Tables 2

并发症情况：随访期间未发现有伤椎邻近节段的椎体骨折。其中实验组发生硬膜外漏1例，血管引流4例，周围软组织外漏9例，邻近椎间盘外漏2例，椎体发生骨水泥外漏共计16节，骨水泥外漏发生率为59.26%；对照组发生硬膜外漏1例，血管引流3例，周围软组织外漏5例，邻近椎间盘外漏20例，椎体发生骨水泥外漏共计29节，骨水泥外漏发生率为59.18%。两组间骨水泥外漏的发生率无显著性意义(P > 0.05)，但是两组间骨水泥外漏类型的分布比较差异有显著性意义(P < 0.05)。所有骨水泥外漏病例均未引发临床并发症。 2.3 典型病例病例1：89岁女性患者，在家中不慎摔倒，即感腰部疼痛，尚能独立行走，未予就医，亦未卧床静养，后腰痛逐渐加重，入院10 d前疼痛加重至不能站立，遂于本院就诊。临床查体：腰椎侧凸、后凸畸形明显，L1棘突压痛(+)，叩痛(+)，棘突旁压痛(+)，双下肢直腿抬高试验(-)，双下肢肌力肌张力正常，皮肤感觉正常，双下肢膝腱反射、跟腱反射可引出，病理反射未引出。入院后行腰椎正侧位片及腰椎MRI检查，诊断为伴椎体裂隙骨质疏松性L1椎体压缩骨折。治疗前目测类比评分和Oswesty功能障碍指数值分别为9分和85分，椎体前缘高度为1.05 cm；经椎体成形治疗后，目测类比评分和Oswesty功能障碍指数分别为1分和20分，椎体前缘高度为1.1 cm，治疗后骨水泥轻度向前上方渗漏，未出现临床症状。治疗前后影像学图片见图1。病例2：59岁男性患者，因腰部扭伤致腰部疼痛，腰部活动尚可，入院1个月前疼痛逐渐加重，逐渐不能站立行走，遂于本院就诊。临床查体：腰椎后凸畸形，L 4棘突压痛(+)，叩痛(+)，棘突旁压痛(+)，双下肢直腿抬高试验(-)，双下肢肌力肌张力正常，皮肤感觉正常，双下肢膝腱反射、跟腱反射可引出，病理反射未引出。既往强直性脊柱炎30年，入院8年前曾于外院行枕颈融合。入院后行腰椎正侧位片及腰椎MRI检查，诊断为伴椎体裂隙骨质疏松性L4椎体压缩骨折。治疗前目测类比评分和Oswesty功能障碍指数值分别为8分和79分，椎体前缘高度为3.0 cm；经椎体成形治疗后，目测类比评分和Oswesty功能障碍指数分别为0分和22分，椎体前缘高度为3.1 cm，治疗后骨水泥弥漫良好，未出现临床症状。治疗前后影像学图片见图2。"

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