骨质疏松性腰椎骨折PVP术前磁共振信号特征与手术效果的相关性

doi:10.3969/j.issn.1671-7171.2023.09.002

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摘要【目的】探讨骨质疏松性腰椎骨折经皮椎体成形术(PVP)术前磁共振信号特征与手术效果的相关性。【方法】选取2019年4月至2022年2月汉中市中心医院收治的92例骨质疏松性腰椎骨折患者,根据骨质疏松性腰椎骨折患者PVP术前MRI信号特征(骨髓水肿信号特征)分为完全骨髓水肿组(n=35)、部分骨髓水肿组(n=33)、无骨髓水肿组(n=24)。比较三组手术情况、疼痛、腰椎功能及腰椎解剖学参数情况,统计两组随访期间再发骨折及并发症发生情况。【结果】三组手术时间、骨水泥注射量、骨水泥渗漏发生率比较,差异均无统计学意义(P>0.05)。完全骨髓水肿组术后1周、术后1个月、术后6个月的疼痛视觉模拟评分(visual analogue scale,VAS)均低于部分骨髓水肿组、无骨髓水肿组(P<0.05),部分骨髓水肿组术后1周、术后1个月、术后6个月的VAS均低于无骨髓水肿组(P<0.05)。完全骨髓水肿组术前、术后6个月的日本骨科协会(JOA)评分差值及Oswestry功能障碍指数(ODI)差值均高于部分骨髓水肿组、无骨髓水肿组(P<0.05)。三组术前、术后6个月的伤椎高度比差值、Cobb角差值比较,差异均无统计学意义(P>0.05)。三组再发骨折率、并发症总发生率比较,差异无统计学意义(P>0.05)。【结论】骨质疏松性腰椎骨折PVP术前磁共振信号特征与手术效果有关,有骨髓水肿患者PVP治疗后疼痛缓解效果及腰椎功能改善情况更佳。

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	屈志强
	刘涛

关键词 ：骨质疏松性骨折/外科学, 椎体成形术/方法, 磁共振成像, 治疗结果

Abstract：【Objective】To investigate the correlation between preoperative magnetic resonance signal characteristics and surgical outcomes of percutaneous vertebroplasty (PVP) for osteoporotic lumbar fractures.【Methods】A total of 92 patients with osteoporotic lumbar spine fractures admitted to the Hanzhong Central Hospital from April 2019 to February 2022 were selected and divided into complete bone marrow edema group (n=35),partial bone marrow edema group (n=33),and no bone marrow edema group (n=24) based on the preoperative MRI signal characteristics (bone marrow edema signal characteristics) of osteoporotic lumbar spine fracture patients. We compared the surgical conditions,pain,lumbar function,and lumbar anatomical parameters of three groups,and counted the incidence of recurrent fractures and complications during the follow-up period between the two groups.【Results】There was no statistically significant difference in the surgical time,amount of bone cement injection,and incidence of bone cement leakage among the three groups (P>0.05). The visual analog scale (VAS) of pain in the complete bone marrow edema group at 1 week,1 month,and 6 months after surgery was lower than that in the partial bone marrow edema group and the non bone marrow edema group (P<0.05). The VAS of the partial bone marrow edema group at 1 week,1 month,and 6 months after surgery was lower than that in the non bone marrow edema group (P<0.05). The difference in the Japanese Orthopedic Association (JOA) score and Oswestry Dysfunction Index (ODI) before and 6 months after surgery in the complete bone marrow edema group were higher than those in the partial bone marrow edema group and the non bone marrow edema group (P<0.05). There was no statistically significant difference in the difference in vertebral height ratio and Cobb angle between the three groups before and 6 months after surgery (P>0.05). There was no statistically significant difference in the incidence of recurrent fractures and total complications among the three groups (P>0.05).【Conclusion】The preoperative magnetic resonance signal characteristics of osteoporotic lumbar spine fracture with PVP are related to the surgical effect,and patients with bone marrow edema have better pain relief and lumbar function improvement after PVP treatment.

Key words： Osteoporotic Fractures/SU Vertebroplasty/MT Magnetic Resonance Imaging Treatment Outcome

收稿日期: 2022-11-28

中图分类号:

R681.4

通讯作者: *E-mail:1945504340@qq.com

引用本文:

屈志强, 刘涛. 骨质疏松性腰椎骨折PVP术前磁共振信号特征与手术效果的相关性[J]. 医学临床研究, 2023, 40(9): 1284-1287.
QU Zhiqiang, LIU Tao. The Correlation between Preoperative Magnetic Resonance Signal Characteristics and Surgical Outcomes in Osteoporotic Lumbar Spine Fractures with PVP Surgery. JOURNAL OF CLINICAL RESEARCH, 2023, 40(9): 1284-1287.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.09.002 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I9/1284

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