摘要
目的分析经皮椎体成形术(PVP)骨水泥渗漏的特点,探讨PVP骨水泥渗漏的风险因素。方法选择我院2016年1月~2018年12月行PVP治疗的111例骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)患者(147个椎体),骨折椎体所在节段术前均行DR、三维CT及MRI检查,术后行DR或/和三维CT复查。分析性别、年龄、椎体位置及椎体损伤情况(裂隙征、骨皮质损伤)对骨水泥渗漏率的影响,及骨水泥渗漏的特点。结果性别、年龄及椎体位置对骨水泥渗漏率的影响无统计学意义;椎体裂隙征合并骨皮质损伤骨水泥渗漏率最高,骨皮质损伤骨水泥渗漏数量最多,差异均有统计学意义(P<0.001);骨水泥椎旁渗漏发生率最高,椎间盘渗漏次之,椎管内渗漏率最低,差异有统计学意义(P=0.005)。结论椎体损伤是PVP治疗骨水泥渗漏发生的重要原因,术前仔细观察椎体损伤的影像学特点对预防骨水泥渗漏具有重要意义。
Objective To analyze the characteristics of percutaneous vertebroplasty(PVP)bone cement leakage,and to investigate the risk factors of PVP bone cement leakage.Methods A total of 111 patients(147 vertebral body)with osteoporotic vertebral compression fractures(osteoporotic vertebral compression fracture,OVCF)who were treated with PVP in our hospital from January 2016 to December 2018 were selected.Preoperative DR,3D CT and MRI examinations were performed for all vertebral segments with fracture,and postoperative DR or 3D CT reexaminations were performed.The effects of gender,age,vertebral body position and vertebral body injury(fissure sign,cortical bone injury)on the rate of bone cement leakage and the characteristics of bone cement leakage were analyzed.Results Gender,age and vertebral body position had no significant effect on the bone cement leakage rate.Vertebral fissure sign combined with cortical injury was related with the highest rate of cement leakage,and cortical injury was related with the highest amount of cement leakage,and the differences were statistically significant(P<0.001).The incidence of bone cement pervertebral leakage was the highest,followed by intervertebral disc leakage and intraspinal leakage in sequence.The difference was statistically significant(P=0.005).Conclusion Vertebral body injury is an important cause of bone cement leakage in PVP treatment.Careful observation of the imaging characteristics of preoperative vertebral body injury is of great significance in prevention of bone cement leakage.
作者
查丁胜
徐武岩
黄嘉文
李亚骐
陈诗君
林振
林宏生
查振刚
吴昊
ZHA Ding-sheng;XU Wu-yan;HUANG Jia-wen;LI Ya-qi;CHEN Shi-jun;LIN Zhen;LIN Hong-sheng;ZHA Zhen-gang;WU Hao(Department of Orthopedics,the First Affiliated Hospital,Jinan University,Guangzhou 510630,China)
出处
《中国临床解剖学杂志》
CSCD
北大核心
2019年第3期316-321,327,共7页
Chinese Journal of Clinical Anatomy
基金
国家自然科学基金青年项目(No.81401766)
广东省医学科研基金(No.B2012196)
暨南大学科研培育与创新基金青年基金(No.21612303)
暨南大学附属第一医院培育基金(No.2012-1)
广东省科技计划项目(2017ZC0007)
广州市科技计划项目(No.201903010630030012)
关键词
骨质疏松性椎体压缩骨折
经皮椎体成形术
椎体损伤
骨水泥渗漏
Osteoporosis vertebral compression fracture
Percutaneous vertebroplasty
Vertebral body injury
Bone cement leakage
作者简介
查丁胜(1979-),男,安徽安庆人,副主任医师,研究方向:骨质疏松症及脊柱脊髓病损的基础与临床研究,E-mail:zdsuser@126.com;通讯作者:吴昊,副教授,E-mail:woohaoo@163.com
