The severity of vertebral fractures and health-related quality of life in osteoporotic postmenopausal women

Vertebral fractures are the hallmark of osteoporosis, responsible for increased back pain, impairment of mobility and functional limitations. These factors have an impact on patients health-related quality of life (QOL). The aim of this study was to assess QOL, using QUALEFFO, in osteoporotic postmenopausal women, according to the number and the severity of the vertebral fractures. A group of 629 osteoporotic postmenopausal women (60–80 years) with symptoms that, according to a rheumatologist, could be related to a vertebral fracture, had spine X-rays with standardized procedures. All the X-rays were assessed in a central facility. The number of fractures was a determinant of a low QOL, as indicated by an increased score in physical function ( P =0.001), social function ( P =0.002) and total score ( P =0.027). Patients with higher grades of vertebral deformities, i.e., more severe fractures, had low QOL in these three domains, too ( P <0.0001, P <0.0001 and P =0.005, respectively). There was no difference in QOL according to the thoracic or lumbar location of the fractures. Both anterior and middle deformities of the vertebral bodies had a negative impact on QOL. In none of the analyses were the pain and mental function domains of QUALEFFO discriminant among the patients. QOL, assessed by an osteoporosis-specific instrument, is decreased in osteoporotic women as a function of both the number and the severity of the vertebral fractures. Treating women with prevalent fractures may avoid a further decrease in their quality of life.     

Accuracy of spinal curvature assessed by a computer-assisted device and anthropometric indicators in discriminating vertebral fractures among individuals with back pain

Summary

This study examined the accuracy of thoracic and lumbar kyphotic angles as well as anthropometric indicators for discriminating patients with vertebral fracture among Japanese women >50 years old with back pain. Along with region-specific kyphotic angles and anthropometric indicators, the combination of thoracic and lumbar kyphotic angles offered the highest accuracy.

Introduction

Vertebral fractures have been associated with thoracic kyphosis. However, reports on lumbar kyphotic changes in association with vertebral fracture are scarce. This study investigated the accuracy of thoracic kyphotic angle (TKA) and lumbar kyphotic angle (LKA) measurements as well as anthropometric indicators (wall–occiput distance (WOD) and rib–pelvis distance (RPD)) in discriminating patients with vertebral fracture.

Methods

Lateral radiographs of the spine were obtained in 70 postmenopausal Japanese women who visited an orthopedic clinic with low back pain (mean age, 76.2?±?9.0 years). Radiographic vertebral fracture was diagnosed using quantitative measurement according to Japanese criteria. Osteoarthritis (OA) was defined as Kellgren–Lawrence (KL) grade 3 or higher. TKA and LKA were measured using SpinalMouse®. WOD and RPD were also measured.

Results

At least one vertebral fracture was present in 49 subjects (70 %). Women with vertebral fractures showed significant increases in LKA, TKA?+?LKA, and WOD and decreases in RPD. Logistic regression analysis showed significant association between TKA?+?LKA and vertebral fracture independent of the presence of OA. Receiver operating characteristic analysis revealed that TKA was useful for discriminating thoracic fractures (area under the curve (AUC), 0.730) and LKA was useful for lumbar fractures (AUC, 0.691). The combination of TKA?+?LKA offered the highest accuracy for detecting thoracic, lumbar, and any vertebral fractures, with AUCs of 0.779, 0.728, and 0.783, respectively. WOD and RPD showed low-to-moderate accuracies for thoracic, lumbar, and any vertebral fractures.

Conclusions

Assessment of spinal kyphosis by SpinalMouse® as well as anthropometric indicators proved useful in discriminating subjects with vertebral fractures. These convenient and radiation-free methods could contribute to early diagnosis of vertebral fractures and subsequent appropriate treatment, thus preventing additional osteoporotic fractures.     

微创球囊扩张椎体后凸成形术治疗中老年胸腰椎骨质疏松压缩性骨折

目的 探讨微创球囊扩张椎体后凸成形术(percutaneous kyphoplasty,PKP)在骨质疏松性胸腰椎压缩性骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效及相关问题.方法 采用球囊扩张PKP治疗椎体OVCF 26例,术前患椎明显疼痛,但无神经症状及体征;术前CT示椎体后壁均完整.结果 26例患者腰背部疼痛在术后24 h缓解并下床活动,椎体高度基本恢复,后凸畸形矫正9°,无脊髓神经损伤、骨水泥漏、肺栓塞等并发症.结论 PKP治疗胸腰椎OVCF可有效缓解疼痛,部分恢复椎体高度,疗效满意.     

Spine fracture with neurological deficit in osteoporosis

The literature suggests that spinal fractures acquired after minimal trauma in osteoporotic patients cause neurological problems only extremely rarely. This report describes 9 patients with severe osteoporosis in whom minimal trauma led to a fracture of the thoracic or lumbar spine causing significant neurological deficit. All patients presented originally with isolated back pain after minimal trauma. Initial radiographs documented what appeared to be benign compression fractures with minimal loss of vertebral height. Over the following 1–12 weeks all patients described a gradual onset of severe radicular pain which was subsequently associated with profound lower extremity weakness in 7 cases. Repeat radiographs revealed advanced collapse of the fractured level. CT and MRI images revealed violation of the posterior cortex of the vertebrae with retropulsion of bone into the spinal canal. In 2 cases, two simultaneous fractures of this kind were noted; in both of these cases the fractures occurred at adjacent levels. The upper lumbar spine was most frequently involved. This relatively small series suggests that caution should be used in the assessment of benign-appearing compression fractures in osteoporotic patients. The delayed appearance of neurological signs and symptoms may lead to a late or missed diagnosis. The onset of back pain in an elderly patient quite frequently represents the acquisition of a fracture; subsequent complaints of leg pain or lower extremity dysfunction may indicate progression of such a fracture, with compromise of the neutral elements.     

The prognosis for pain, disability, activities of daily living and quality of life after an acute osteoporotic vertebral body fracture: its relation to fracture level, type of fracture and grade of fracture deformation

The level of the acute osteoporotic vertebral fracture, fracture type and grade of fracture deformation were determined in 107 consecutive patients and related to pain, disability, activities of daily living (ADL) and quality of life (QoL) after 3 weeks, 3, 6 and 12 months. Two-thirds of the fractured patients were women and with a similar average age, around 75 years, as the men. Fifty-eight of the acute fractures were located in the thoracic spine and 49 in the lumbar spine and predominantly at the Th12 and L1 levels. Sixty-nine percent of the fractures were wedge, 19% concave and 12% crush fractures. There were 22 mildly, 50 moderately and 35 severely deformed vertebrae. The grade of fracture deformation was not related to gender, age or fracture location. Severely deformed vertebrae predominantly (92%) occurred among the crush fracture type. One year after the fracture, irrespective of fracture level, fracture type or grade of fracture deformation, 4/5 still had pronounced pain and deteriorated QoL. Initial severe fracture deformation by far was the worst prognostic factor for severe lasting pain and disability, and deterioration of ADL and QoL. Factors like fracture level, lumbar fractures tended to improve steadily while thoracic deteriorated, type of fracture, the wedge and concave resulting in less pain and better QoL than the crush fracture type and gender influenced to a lesser extent the outcomes during the year after the acute fracture.     

改良五禽戏配合穴位敷贴治疗骨质疏松性椎体骨折的临床疗效观察

目的观察改良五禽戏配合穴位敷贴治疗骨质疏松性椎体骨折的临床疗效。方法选取2013年在我院行保守治疗的骨质疏松性椎体骨折患者80例,给予改良五禽戏配合穴位敷贴治疗,分别在治疗前和治疗6个月后测量患者腰椎骨密度及腰背部疼痛评分。结果治疗6个月后,患者的腰椎骨密度及疼痛评分较治疗前均有明显改善(P0.05)。结论改良五禽戏配合穴位敷贴是治疗骨质疏松性椎体骨折一种有效的方法。     

Concomitant and previous osteoporotic vertebral fractures

Background and purpose — Patients with osteoporosis who present with an acute onset of back pain often have multiple fractures on plain radiographs. Differentiation of an acute osteoporotic vertebral fracture (AOVF) from previous fractures is difficult. The aim of this study was to investigate the incidence of concomitant AOVFs and previous OVFs in patients with symptomatic AOVFs, and to identify risk factors for concomitant AOVFs.

Patients and methods — This was a prospective epidemiological study based on the Registry of Pathological Osteoporotic Vertebral Fractures (REPAPORA) with 1,005 patients and 2,874 osteoporotic vertebral fractures, which has been running since February 1, 2006. Concomitant fractures are defined as at least 2 acute short-tau inversion recovery (STIR-) positive vertebral fractures that happen concomitantly. A previous fracture is a STIR-negative fracture at the time of initial diagnostics. Logistic regression was used to examine the influence of various variables on the incidence of concomitant fractures.

Results — More than 99% of osteoporotic vertebral fractures occurred in the thoracic and lumbar spine. The incidence of concomitant fractures at the time of first patient contact was 26% and that of previous fractures was 60%. The odds ratio (OR) for concomitant fractures decreased with a higher number of previous fractures (OR =0.86; p = 0.03) and higher dual-energy X-ray absorptiometry T-score (OR =0.72; p = 0.003).

Interpretation — Concomitant and previous osteoporotic vertebral fractures are common. Risk factors for concomitant fractures are a low T-score and a low number of previous vertebral fractures in cases of osteoporotic vertebral fracture. An MRI scan of the the complete thoracic and lumbar spine with STIR sequence reduces the risk of under-diagnosis and under-treatment.     

Treatment of lower lumbar radiculopathy caused by osteoporotic compression fracture: the role of vertebroplasty

The authors used vertebroplasty for the treatment of severe lower lumbar radicular pain caused by osteoporotic compression fracture. Patients presented with severe radiating leg pain rather than lower back pain from recent osteoporotic compression fracture of lower lumbar vertebra. Radiologic findings showed osteoporotic compression fracture combined with preexisting stenosis of the intervertebral foramen resulting in root compression. After injection of polymethylmethacrylate into the compressed vertebral body through the pedicle of the symptomatic side, all seven patients experienced dramatic pain relief that lasted throughout the mean follow-up duration of 9.1 months. They conclude that vertebroplasty may be an effective way of relieving radicular pain caused by osteoporotic compression fracture combined with foraminal stenosis.     

椎体后凸成形术治疗伴有肋间痛的胸椎压缩性骨折的临床疗效分析

目的:观察椎体后凸成形术治疗胸椎骨质疏松性椎体压缩性骨折并肋间痛患者的疗效,并初步分析其原因。方法:2014年5月至2016年5月,共纳入188例行椎体后凸成形术的胸椎骨质疏松性椎体压缩性骨折患者,按照患者是否有肋间痛分为肋间痛组和无肋间痛组。术后采用疼痛视觉模拟评分(visual analogue scale,VAS)及Oswestry功能障碍指数(Oswestry Disability Index,ODI)评估两组的疗效。比较两组患者的性别、年龄、骨折部位、骨密度、骨折类型,骨折严重程度,分析肋间痛出现的原因。结果:肋间痛组为38例,无肋间痛组为150例,肋间痛的发生率为20.2%。随访时间为6~15个月,平均为8.3个月。两组术后VAS评分及ODI指数均明显下降(P0.05);组间比较,术后3 d及术后1个月差异有统计学意义(P0.05),术后6个月差异无统计学意义(P0.05)。肋间痛组的患者扁平形骨折及严重骨折出现率高,两组骨折类型和骨折严重程度差异有统计学意义(P0.05)。结论:胸椎骨质疏松性压缩性骨折的肋间痛与骨折类型和骨折严重程度有关。椎体后凸成形术对肋间痛有缓解不佳的可能,尤其是术后早期。     

Treatment of pain from osteoporotic vertebral collapse by percutaneous PMMA vertebroplasty

Summary Background. Vertebral compression fractures are common complications in advanced osteoporosis. In general, this disease of the elderly patient is characterized by severe local back pain. Pathophysiologically, bony instability triggers local pain during body movement. Serious pain immobilizes the patients and forces them to bed rest. As a result, complications like thrombosis or pneumonia occur. Invasive treatment with surgical instrumentation for vertebral stabilization is not indicated in elderly patients especially with additional diseases.The purpose of this study was to test the hypothesis that percutaneous polymethylmethacrylate (PMMA) vertebroplasty significantly reduces pain due to vertebral collapse in osteoporotic patients and improves quality of life.Methods. A total of 38 patients with osteoporotic vertebral compression fractures of the thoracic and lumbar spine were treated by PMMA vertebroplasty. After admission, before discharge from the hospital, six weeks, half a year and one year later patients answered the Oswestry Low Back Pain Disability (OLBPD) Questionnaire for assessment of treatment related change in disability. In all patients percutaneous vertebroplasty was performed under local anesthesia.Findings. A total of 92% of patients reported a significant pain reduction immediately after treatment. Also one year after vertebroplasty pain remained significantly reduced. Vertebroplasty was highly beneficial for patients with pain related to local instability of the spine. Extravasation of PMMA beyond the vertebral margins was observed in 26% of the cases. No treatment related clinical or neurological complications were noticed.Interpretation. PMMA vertebroplasty is a useful and safe method of pain relief which rapidly regains quality of life for patients with osteoporotic vertebral compression.     

Vertebral fractures in late adolescence: a 27 to 47-year follow-up

The long-term outcome of thoracic and lumbar fractures in late adolescence is sparsely described and it is unclear whether a fractured vertebral body in these years, as in young children, can be resituated in height. The purpose of this study was to in late adolescence determine the incidence, the long-term outcome and the modelling capacity in fractures of the thoracic and lumbar region. The incidence of vertebral fractures 1950–1971 in individuals aged 16–18 years was through the radiological archives evaluated in a city cohort of 228,878 citizens, of whom 13,893 were aged 16–18. A follow-up, 27–47 years after the injury, including subjective, objective and radiological evaluation was conducted in 18 boys and 5 girls. Twenty-nine boys and 11 girls were registered with a thoracic or lumbar vertebral fracture during the study period conferring an annual incidence of 0.14‰. Of the 23 individuals that attended the follow-up, 14 had one-column compression fractures, one a Denis type A, six a Denis type B, one a Denis type D and one a Chance fracture. At injury, one had a partial paresis in one leg and one developed a transient paraparesis during the first week. All were treated non-operatively. At follow-up, 18 individuals had no complaints while 5 had occasional back pain, 20 were classified as Frankel E and 3 as Frankel D. The radiographic ratio of anterior height to posterior height of the fractured vertebral body was unchanged during the study period. Thoracic and lumbar vertebral fractures in late adolescence with no or minor neurological deficits have a predominantly favourable long-term outcome, even if no modelling capacity of the fractured vertebral body remains in late adolescence.     

First fractures among postmenopausal women with osteoporosis

After the occurrence of the first fracture, osteoporosis is no longer a “silent” disease, and the patient’s risk for future fracture is increased several fold. We assessed the location of first osteoporotic fractures among women with osteoporosis. The Multiple Outcomes of Raloxifene Evaluation (MORE) trial was a fracture outcomes study of postmenopausal women with osteoporosis. All subjects received supplements containing 500 mg elemental calcium and 400–600 IU vitamin D. We assessed the location of first fractures among women with osteoporosis and no previous fractures at baseline from the placebo group of this trial after 3 years of follow-up. Prespecified fracture sites included vertebral fractures and nonvertebral fractures as defined in the MORE study protocol. Among 875 women (mean age, 64.5 ± 7.4 years) with no prevalent vertebral or nonvertebral fractures, 9% experienced their first fracture event during the trial. Fractures of radius and spine each occurred in 3% of patients. Fractures at other individual sites included ankle (0.6%), metatarsal (0.6%), humerus (0.5%), rib (0.5%), patella (0.3%), leg (0.2%), hip (0.2%), and clavicle (0.1%). These data suggest that for postmenopausal women with osteoporosis but no previous fractures, skeletal care should include a focus on preventing spine and radius fractures.     

Reduction of pain and fracture incidence after kyphoplasty: 1-year outcomes of a prospective controlled trial of patients with primary osteoporosis

Previously, we reported significantly reduced pain and improved mobility persisting for 6 months after kyphoplasty of chronically painful osteoporotic vertebral fractures in the first prospective controlled trial. Since improvement of spinal biomechanics by restoration of vertebral morphology may affect the incidence of fracture, long-term clinical benefit and thereby cost-effectiveness, here we extend our previous work to assess occurrence of new vertebral fractures and clinical parameters 1 year after kyphoplasty compared with a conservatively treated control group. Sixty patients with osteoporotic vertebral fractures due to primary osteoporosis were included: 40 patients were treated with kyphoplasty, 20 served as controls. All patients received standard medical treatment. Morphological characteristics, new vertebral fractures, pain (visual analog scale), physical function [European Vertebral Osteoporosis Study (EVOS) score] (range 0–100 each) and back-pain-related doctors visits were re-assessed 12 months after kyphoplasty. There were significantly fewer patients with new vertebral fractures of the thoracic and lumbar spine, after 12-months, in the kyphoplasty group than in the control group (P=0.0084). Pain scores improved from 26.2 to 44.4 in the kyphoplasty group and changed from 33.6 to 34.3 in the control group (P=0.008). Kyphoplasty treated patients required a mean of 5.3 back-pain-related doctors visits per patient compared with 11.6 in the control group during 12 months follow-up (P=0.006). Kyphoplasty as an addition to medical treatment and when performed in appropriately selected patients by an interdisciplinary team persistently improves pain and reduces occurrence of new vertebral fractures and healthcare utilization for at least 12 months in individuals with primary osteoporosis.     

四步法单侧入路椎体成形术在胸椎骨质疏松性骨折中的应用

目的探讨四步法单侧入路的经皮椎体成形术(PVP)在胸椎骨质疏松性骨折中的应用。方法运用四步法,对胸椎骨质疏松性骨折椎体进行单侧入路的经皮椎体成形术,计录手术时间,观察骨水泥弥散分布情况,在术前、术后3 d、术后12个月随访时进行疼痛视觉类比评分(VAS)。结果18例21个椎体操作均成功,手术时间10~25 min,平均(16±2.2)min,骨水泥在椎体内弥散分布均越过椎体中线,VAS评分由术前(8.5±1.2)分降低至(2.5±1.4)分,术后效果良好。结论四步法单侧入路椎体成形术治疗胸椎骨质疏松性骨折简单快速、安全有效。     

Acromegaly is associated with vertebral deformations but not vertebral fractures: Results of a cross-sectional monocentric study

ObjectivesPatients with acromegaly appear to be at increased risk of vertebral fractures despite normal bone mineral density. We investigated the prevalence of vertebral fractures in a cohort of acromegalic patients under 80 years of age.MethodsMonocentric cross-sectional study performed at Nantes University Hospital from 1988 to 2018. Fifty patients (18 females, 32 males) with a median age of 52.3 years (range: 27–78) were included. Radiological vertebral fractures were evaluated on conventional lumbar and thoracic spine radiographs using Genant's semiquantitative fracture assessment. We studied qualitative abnormalities of the spine using three criteria: osteophytes, disc-space narrowing and wedge-shaped vertebrae. We analysed bone mineral density and endocrine status.ResultsThree patients (6%) had a vertebral fracture: one grade 1 and two grade 2 according to Genant's assessment, with two osteoporotic and one osteopenic patients. They had no unsubstituted pituitary deficiency. Considering the frank deformations (osteophyte or disc narrowing ≥ grade 2 or wedge-shaped), the thoracic spine was deformed in 22 patients (44%) and the lumbar spine in 21 patients (42%).ConclusionAcromegalic patients had a low prevalence of vertebral fractures but had a significant amount of vertebral deformations. We speculate that this high prevalence of frank deformations could explain the previously reported high prevalence of vertebral fractures.     

Converted Lumbar BMD Values Derived from Sagittal Reformations of Contrast-Enhanced MDCT Predict Incidental Osteoporotic Vertebral Fractures

We obtained baseline and follow-up bone mineral density (BMD) values of the lumbar spine from sagittal reformations of routine abdominal contrast-enhanced multidetector computed tomography (MDCT) using a reference phantom and assessed their performance in differentiating patients with no, existing, and incidental osteoporotic fractures of the spine. A MDCT-to-QCT (quantitative computed tomography) conversion equation for lumbar BMD measurements was developed by using 15 postmenopausal women (63 ± 12 years), who underwent standard lumbar QCT (L1-L3) and afterward routine abdominal contrast-enhanced MDCT. Sagittal reformations were used for corresponding lumbar BMD measurements. The MDCT-to-QCT conversion equation was applied to baseline and follow-up routine abdominal contrast-enhanced MDCT scans of 149 postmenopausal women (63 ± 10 years). Their vertebral fracture status (no, existing, or incidental osteoporotic fracture) was assessed in the sagittal reformations. A correlation coefficient of r = 0.914 (p < 0.001) was calculated for the BMD values of MDCT and standard QCT with the conversion equation BMD(QCT) = 0.695 × BMD(MDCT) - 7.9 mg/mL. Mean follow-up time of the 149 patients was 20 ± 12 months. Fifteen patients (10.1 %) had an existing osteoporotic vertebral fracture at baseline. Incidental osteoporotic vertebral fractures were diagnosed in 13 patients (8.7 %). Patients with existing and incidental fractures showed significantly (p < 0.05) lower converted BMD values (averaged over L1-L3) than patients without fracture at baseline and at follow-up. In this longitudinal study, BMD values of the lumbar spine derived from sagittal reformations of routine abdominal contrast-enhanced MDCT predicted incidental osteoporotic vertebral fractures.     

骨质疏松症患者腰椎平均BMD与腰椎椎体骨折相关性研究

目的 探讨骨质疏松症患者腰椎平均骨密度(BMD)与腰椎椎体骨折的关系.方法 选择2010年1月~2011年1月来我院治疗骨质疏松性椎体骨折96例患者为骨折组,42例无腰椎椎体骨折者作为对照组.采用双能X线骨密度仪对两组患者腰椎正位(L2-4)BMD进行测定.结果 骨质疏松患者腰椎椎体骨折组患者BMD相对对照组较低,差异具有统计学意义(P<0.05).结论 腰椎BMD降低与绝经后妇女的骨质疏松性椎体骨折相关.     

Double-level posterior spinal shortening for paralytic osteoporotic vertebral collapse of two vertebral bodies with a normal vertebra in between: a case report

Introduction  Spinal shortening is indicated for osteoporotic vertebral collapse. However, this surgical procedure has not been indicated for more than two vertebral levels that are not adjacent. We experienced a rare case of paraparesis due to osteoporotic vertebral collapse of two vertebral bodies with a normal vertebra in between and treated successfully by the double-level posterior shortening procedure. Materials and methods  A 79-year-old woman suffered from delayed paraparesis 2 years after L1 and Th11 vertebral body compression fracture. Plain X-ray photographs showed Th11 and L1 vertebral body collapse, Th7 compression fracture and a kyphosis angle of 30° from Th10 to L2. Plain magnetic resonance imaging showed spinal canal stenosis at Th11 and L1 vertebral body levels. She was treated by double-level posterior spinal shortening using pedicle screw and hook systems. Results  After the procedure, the patient’s kyphosis angle decreased to 10° and her back pain, leg pain, and sensory deficits improved. She was able to walk by herself. Although new vertebral compression fractures occurred at L4 and L5 in the follow-up period, there has been no deterioration of the neurological symptoms 5 years after the operation. Conclusion  Delayed paraparesis after double-level thoracolumbar vertebral collapse due to osteoporosis was treated successfully by double-level posterior spinal shortening using a pedicle screw and hook system.     

Vertebral body compression fracture after removal of pedicle screws: a report of two cases

While the risks of pedicle screw insertion are well established, there is a paucity of reports on complications associated with implant removal. We report two cases of acute osteoporotic vertebral compression fractures of the instrumented vertebral body adjacent to the fractured vertebra due to removal of pedicle screws in two female patients previously treated for vertebral lumbar burst fractures. Both patients had experienced only mild occasional pain at the thoracolumbar junction prior to the removal of the implants. In the formerly almost asymptomatic individuals, the acute osteoporotic fractures led to persistent severe back pain despite prolonged intensive treatment. Patients must be thoroughly informed of the rare but potential risks of spinal implant removal, particularly in cases of osteoporosis. We therefore do not recommend removal of spinal implants unless there are clear clinical indications for implant removal.     

气囊扩张椎体后凸成形术的初步报告

目的:初步评价气囊扩张后突成形术治疗骨质疏松性椎体压缩骨折的手术操作、安全性、及疗效。方法:观察21例骨质疏松患者,30节椎体,新鲜骨折24椎节,陈旧性骨折6椎节,均有局部腰背疼痛,无神经症状。C-arm透视下,两侧同时经皮穿刺,气囊扩张骨折复位后,骨水泥灌注入椎体。随访4～7月。记录患者局部止痛的疗效,骨折的复位,及并发症等情况。结果:完全止痛14例,部分止痛7例,24节新鲜骨折气囊扩张的复位率是28.2％,6节陈旧性骨折复位率是2.1％。并发症2例,骨水泥外漏到椎间隙。其他椎体再次骨折2例,余无疼痛复发及椎体高度丢失。结论:气囊扩张后突成形术能恢复脊柱的稳定性,部分矫正脊柱后突,止痛疗效好,创伤小,并发症少,值得推广。