The dynamic mobility of vertebral compression fractures
The dynamic mobility of vertebral compression fractures
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DOI：
10.1359/jbmr.2003.18.1.24
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发表时间：
2003-01-01
影响因子：
6.2
通讯作者：
Faciszewski, T
中科院分区：
文献类型：
--
作者：
McKiernan, F;Jensen, R;Faciszewski, T
我们观察到一些骨质疏松性椎体压缩性骨折（VCF）是可移动的。本报告的目的是记录动态骨折活动度的存在，估计转诊椎体成形术的患者动态活动度的频率，定义动态活动度的幅度和性质，并考虑骨质疏松 VCF 动态活动度的影响。这是对 41 名连续接受椎体成形术、有 65 个 VCF 的患者进行的前瞻性放射学分析。将术前骨折椎骨的站立侧位X光片与仰卧跨台侧位X光片进行比较，以确定是否存在动态活动度。评估术后站立侧位X光片以记录骨折活动度并评估最终椎体高度恢复情况。将射线照片手动数字化以计算椎体形态测量。 44% 接受椎体成形术的患者（治疗椎骨的 35%）显示出动态骨折活动度。术后，在活动性骨折中，与初始骨折高度相比，平均前椎高度增加了 106%（绝对增加，8.41 +/- 0.4 mm）。平均侧椎面积从正常的 48% 增加到 80%，后凸角减少 40%。活动性骨折主要发生在胸腰椎交界处。在每个活动性骨折中都定义并识别了椎内裂隙，而在每个非活动性（固定）骨折中不存在椎内裂隙。该射线照相系列记录了许多骨质疏松 VCF 中以前未被识别的动态骨折活动度的发生。骨折活动度可能很大且具有临床意义。任何声称恢复椎体高度的干预措施都必须控制动态骨折活动度的发生。
We have observed that some osteoporotic vertebral compression fractures (VCFs) are mobile. The purpose of this report was to document the existence of dynamic fracture mobility, estimate the frequency of dynamic mobility in patients referred for vertebroplasty, define the magnitude and nature of dynamic mobility, and consider the implications of the dynamic mobility of osteoporotic VCFs. This was a prospective radiographic analysis of 41 consecutive patients with 65 VCFs who underwent vertebroplasty. Preoperative standing lateral radiographs of the fractured vertebrae were compared with supine cross-table lateral radiographs to determine the presence or absence of dynamic mobility. Postoperative standing lateral radiographs were evaluated to document fracture mobility and assess final vertebral height restoration. Radiographs were manually digitized to calculate vertebral body morphometrics. Dynamic fracture mobility was demonstrated in 44% of patients (35% of treated vertebrae) who underwent vertebroplasty. Postoperatively, in mobile fractures, average anterior vertebral height increased 106% compared with initial fracture height (absolute increase, 8.41 +/- 0.4 mm). Mean lateral vertebral area increased from 48% to 80% of normal,, and kyphotic angle decreased 40%. Mobile fractures dominated at the thoracolumbar junction. Intravertebral clefts were defined and identified in every mobile fracture and were absent from every nonmobile (fixed) fracture. This radiographic series documents the previously unrecognized occurrence of dynamic fracture mobility in many osteoporotic VCFs. Fracture mobility can be substantial and clinically significant. Any intervention that claims vertebral height restoration must control for the occurrence of dynamic fracture mobility.