Incidence and risk factors of facet joint violation following percutaneous kyphoplasty for osteoporotic vertebral compression fractures
Incidence and risk factors of facet joint violation following percutaneous kyphoplasty for osteoporotic vertebral compression fractures
复制标题
骨质疏松性椎体压缩性骨折经皮椎体后凸成形术后小关节侵犯的发生率及危险因素
DOI：
10.1177/0284185118799515
复制
发表时间：
2019-06-01
期刊：
影响因子：
1.3
通讯作者：
Wu, Yaosen
中科院分区：
文献类型：
--
作者：
Li, Yao;Wang, Xiangyang;Wu, Yaosen
背景经皮椎体后凸成形术（PKP）已被广泛应用于骨质疏松性椎体压缩骨折（OVCF）。既往研究未报道PKP引起小关节侵犯（FJV）的发生率和危险因素。目的探讨卵巢卵囊囊性纤维化（OVCF）患者经皮肾移植（PKP）后FJV的发生率及危险因素。材料与方法我们回顾了153例接受双侧PKP的患者。术后计算机断层扫描（CT）进行了评估，以确定由于穿刺套管针侵入FJV的程度。收集所有患者的临床结局，包括视觉模拟量表（VAS）评分和奥斯韦斯特里功能障碍指数（ODI）评分。分析临床和影像学资料，以确定FJV的危险因素。结果PKP引起的FJV累及18.9%的患者和9.6%的小关节，分别约3.9%和5.7%的小关节有1级和2级侵犯。术后FJV组和非FJV组的VAS和ODI评分存在显著差异。在小关节角度（FJA）、椎弓根直径（PD）和从入路点到小关节间隙（DEF）的距离方面发现了显著差异。多因素Logistic回归分析显示FJA > 55°、PD < 5 mm、DEF < 5 mm是FJV的独立危险因素。结论穿刺套管针的放置可引起OVCF患者的FJV，影响PKP的临床疗效。应特别注意FJA > 55°、PD < 5 mm和DEF < 5 mm的患者。
Background Percutaneous kyphoplasty (PKP) has been widely used to osteoporotic vertebral compression fractures (OVCFs). No previous investigations have reported the incidence and risk factors of facet joint violation (FJV) caused by PKP. Purpose To determine the incidence and risk factors of FJV following PKP in patients with OVCFs. Material and Methods We reviewed a total of 153 patients who underwent bilateral PKP. Postoperative computed tomography (CT) scans were assessed to determine the degree of FJV owing to invasion by a puncture trocar. Clinical outcomes, including visual analogue scale (VAS) scores and Oswestry Disability Index (ODI) scores, were collected from all patients. Clinical and radiological data were analyzed to identify the risk factors for FJV. Results FJV caused by PKP affected 18.9% of patients and 9.6% of facet joints; approximately 3.9% and 5.7% of facet joints were considered to have grade 1 and grade 2 violations, respectively. There were significant differences between the FJV and non-FJV groups in VAS and ODI scores after surgery. Significant differences were found with respect to the facet joint angle (FJA), the pedicle diameter (PD), and the distance from the entry point to the facet joint space (DEF). Multiple logistic regression analysis indicated that an FJA > 55°, a PD < 5 mm, and a DEF < 5 mm were independent risk factors for FJV. Conclusion The placement of a puncture trocar can cause FJV in patients with OVCFs and impact clinical outcomes after PKP. Special attention should be given to patients with an FJA > 55°, a PD < 5 mm, and a DEF < 5 mm.