Significance of Dynamic Mobility in Restoring Vertebral Body Height in Vertebroplasty
Significance of Dynamic Mobility in Restoring Vertebral Body Height in Vertebroplasty
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DOI：
10.3174/ajnr.a2726
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发表时间：
2012-01-01
影响因子：
3.5
通讯作者：
Hsu, H. -C.
中科院分区：
文献类型：
--
作者：
Chen, Y. -J.;Chen, H. -Y.;Hsu, H. -C.
背景和目的：许多作者报道了椎体成形术后椎体高度的增加。然而，McKiernan 等人证明了接受椎体成形术的患者的动态活动性，并得出结论，任何声称椎体高度恢复的文章都必须控制骨折椎骨的动态活动性。本研究的目的是比较椎体成形术前（仰卧交叉台，下方有支撑）与椎体成形术后的椎体高度，以了解椎体成形术本身是否确实增加了椎体高度。 材料和方法：从 2005 年 7 月至 2010 年 7 月，连续 102 例 132 个 VCF 患者在我们机构接受了椎体成形术。椎体成形术的适应症是对药物治疗无反应的剧烈疼痛以及经磁共振成像证实的水肿性病变。将椎体成形术前（仰卧交叉台，下方有垫枕）侧位X线照片与椎体成形术后X线照片进行比较，以评估椎体成形术中的高度变化。测量后凸角和前椎体高度。结果：患者年龄范围为62～90岁。其中男性 16 名，女性 86 名。带垫枕仰卧十字台与椎体成形术后后凸角差异为-0.49±3.59°（范围-9°~16°），无统计学意义（P=0.124）。带垫枕仰卧交叉台与椎体成形术后椎体前部高度差异为 0.84 +/- 3.01 mm（范围：-7.91-8.81 mm），具有统计学意义（P = .002）。结论：椎体成形术中椎体高度的恢复似乎主要是由于骨折椎体的动态活动性；椎体成形术本身对于椎体高度的恢复没有多大贡献。
BACKGROUND AND PURPOSE: Many authors have reported the increase in vertebral body height after vertebroplasty. However, McKiernan et al demonstrated dynamic mobility in patients who underwent vertebroplasty and concluded that any article that claims vertebral height restoration must control for the dynamic mobility of fractured vertebrae. The purpose of this study was to compare prevertebroplasty (supine cross-table with a bolster beneath) with postvertebroplasty vertebral body height to find out whether vertebroplasty itself really increases the vertebral height.MATERIALS AND METHODS: From July 2005 to July 2010, 102 consecutive patients with 132 VCFs underwent vertebroplasty at our institution. The indications for vertebroplasty were severe pain that was not responsive to medical treatment, and MR imaging-confirmed edematous lesions. Prevertebroplasty (supine cross-table with bolster beneath) lateral radiographs were compared with postvertebroplasty radiographs to evaluate the height change in vertebroplasty. Kyphotic angle and anterior vertebral body height were measured.RESULTS: The patients ranged in age from 62 to 90 years. There were 16 men and 86 women. The difference in the kyphotic angle between supine cross-table with bolster and postvertebroplasty was -0.49 +/- 3.59 degrees (range, -9 degrees-16 degrees), which was not statistically significant (P = 0.124). The difference in the anterior vertebral body height between supine cross-table with bolster and postvertebroplasty was 0.84 +/- 3.01 mm (range, -7.91-8.81 mm), which was statistically significant (P = .002).CONCLUSIONS: The restoration of vertebral body height in vertebroplasty seems to be mostly due to the dynamic mobility of fractured vertebrae; vertebroplasty itself does not contribute much to the restoration of vertebral height.