Predictors of treatment effect and subsequent fracture after percutaneous vertebroplasty

经皮椎体成形术后治疗效果和后续骨折的预测因素

基本信息

批准号：
19790879
负责人：
HIWATASHI Akio
金额：
$ 2.42万
依托单位：
Kyushu University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Young Scientists (B)
财政年份：
2007
资助国家：
日本
起止时间：
2007 至 2009
项目状态：
已结题

项目摘要

BACKGROUND AND PURPOSE : Subsequent fracture is often seen after percutaneous vertebroplasty. The purpose of this prospective study was to evaluate preoperative multi-detector row computed tomography (MDCT) for predicting subsequent fractures after vertebroplasty.MATERIALS AND METHODS : This study included 26 consecutive patients (18 women and 8 men) with osteoporotic compression fractures (58 vertebrae). Sixty-four-slice MDCT with multiplanar reformation was obtained within a day before the procedure. Repeat magnetic resonance (MR) imaging was used to evaluate new fractures at least three months after treatment on a routine basis or if there was recurrent pain. We used logistic regression analysis with MDCT findings and clinical data for statistical evaluation according to the location of new fractures.RESULTS : Subsequent fractures were noted at 14 adjacent vertebrae (12.1%) in 13 patients and at 14 remote vertebrae in 6 patients (23.1%). Subsequent fractures in adjacent vertebrae tended to occur in small vertebrae before treatment (P < .05). Steroid medication and low CT value in nonfractured vertebrae were associated with subsequent fractures in remote vertebrae (P < .05). Further collapse of the treated vertebral bodies was noted in 10 patients (11 vertebrae, 19.0 %) without specific findings (P > .05). CONCLUSION: The small size of the treated vertebrae may relate to subsequent fracturesin adjacent vertebrae. Steroid use and low CT value of nonfractured vertebrae on preoperative MDCT can be associated with subsequent fractures in remote vertebrae.

背景和目的：经皮椎骨成形术后经常看到随后的骨折。这项前瞻性研究的目的是评估术前多探测行行计算机断层扫描（MDCT），以预测椎骨后的后续裂缝。材料和方法：该研究包括26例连续的患者（18名女性和8名男性）患有骨质肌动物的压缩性骨折（58个毛比）。在手术前一天，获得了六十四个带有多平面改革的MDCT。重复磁共振（MR）成像至少在常规治疗后至少三个月后评估新的骨折，或者是否存在疼痛。我们根据新骨折的位置使用了Logistic回归分析和MDCT发现和临床数据进行统计评估。分析：13例患者的14例邻近椎骨（12.1％）在14例偏远的椎骨（12.1％）中，在6例患者中有14例远程椎骨（23.1％）（23.1％）。在治疗前，邻近椎骨的随后骨折倾向于在小椎骨中发生（p <.05）。非裂缝椎骨中的类固醇药物和低CT值与远程椎骨的随后骨折有关（p <.05）。在没有具体发现的情况下，有10例患者（11例椎骨，19.0％）发现了处理过的椎体的进一步崩溃（p> .05）。结论：经过处理的椎骨的小尺寸可能与邻近椎骨的随后分裂有关。术前MDCT上非裂缝椎骨的类固醇使用和低CT值与远程椎骨的后续裂缝有关。