New Vertebral Compression Fractures After Prophylactic Vertebroplasty in Osteoporotic Patients
New Vertebral Compression Fractures After Prophylactic Vertebroplasty in Osteoporotic Patients
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DOI：
10.2214/ajr.10.5937
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发表时间：
2011-08-01
影响因子：
5
通讯作者：
Numaguchi, Yuji
中科院分区：
文献类型：
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作者：
Kamano, Hironori;Hiwatashi, Akio;Numaguchi, Yuji
objective.先前的研究表明，在经皮椎体成形术治疗压缩性骨折期间，对非骨折椎体预防性注射骨水泥可能有效。本研究的目的是调查预防性经皮椎体成形术后继发骨折的危险因素。本回顾性研究纳入了116例接受预防性经皮椎体成形术的椎体压缩性骨折患者。在经皮椎体成形术后1天、3个月和12个月，对患者进行体格检查和X线片监测，以及背痛是否复发。我们分析了以下多个协变量，以确定它们是否与复发相关：年龄，性别，类固醇使用，术前未愈合或慢性压迫性疼痛的数量。术后3个月内，21例患者（18.1%）的26个椎体发生任何椎体的后续骨折，12个月内，28例患者（24.1%）发生36个椎体的后续骨折。12个月内后续骨折的发生取决于术前未愈合椎体的数量：1个椎体的发生率为16.9%（11/65），2个椎体的发生率为27.0%（10/37），3个或更多椎体的发生率为50.0%（7/14）。三处或三处以上骨折患者的后续骨折发生率明显高于单处骨折患者（p < 0.05）。其他因素差异无统计学意义。有三处或三处以上骨折的患者倾向于发生后续骨折，尽管接受了预防性经皮椎体成形术。然而，预防性经皮椎体成形术并没有增加后续骨折的风险。
objective. Previous studies have shown the possible efficacy of prophylactic cement injection for nonfractured vertebrae during percutaneous vertebroplasty for compression fractures. The purpose of this study was to investigate risk factors for subsequent fractures after prophylactic percutaneous vertebroplasty.MATERIALS AND METHODS. This retrospective study included 116 patients with osteoporotic compression fractures who underwent prophylactic percutaneous vertebroplasty. The patients were monitored with physical examinations and radiographs at 1 day and at 3 and 12 months after percutaneous vertebroplasty, and if back pain recurred. We analyzed the following multiple covariates to determine whether they were associated with recurrence: age, sex, steroid use, and the preoperative number of unhealed or chronic compression fractures.RESULTS. Subsequent fractures in any vertebra occurred within 3 months after the procedure at 26 vertebrae in 21 patients (18.1%), and 36 occurred in 28 patients (24.1%) within 12 months. The occurrence of subsequent fractures within 12 months depended on the preoperative number of unhealed vertebrae: the occurrence rate was 16.9% (11/65) for one vertebra, 27.0% (10/37) for two vertebrae, and 50.0% (7/14) for three or more vertebrae. The incidence of subsequent fractures was significantly higher in patients with three or more fractures than in those with one fracture (p < 0.05). There were no statistically significant differences for the other factors.CONCLUSION. Patients with three or more fractures tended to have subsequent fractures, despite undergoing prophylactic percutaneous vertebroplasty. However, there was no increased risk of subsequent fractures related to prophylactic percutaneous vertebroplasty.