Prediction of hip osteoporotic fractures from composite indices of femoral neck strength

Objective

To clarify whether composite hip strength indices improve predictive ability for hip osteoporotic fractures independent of conventional bone mineral density (BMD).

Subjects and methods

Three hundred and eighty-two health controls and 43 women with hip fractures (aged 28.2–87.7 years, mean age 59.5±9.2 years) were measured by dual energy X-ray absorptiometry for femoral neck bone mineral density (FN_BMD) and proximal femur geometry parameters of hip, and composite hip strength indices (Compression strength index, Bending strength index, and Impact strength index). The association between the studied parameters and the fractures was modelled using multiple logistic regression, including age, height, weight, and menopausal status. Fracture-predicted probability was calculated for each predictor tested. ROC curve areas (AUCs) were calculated for the fracture status, having the calculated fracture-predicted probability as a test variable. AUCs were compared by the Hanley–McNeil test.

Results

Women with hip fractures had lower FN_BMD, composite hip strength indices, and longer hip axis length than controls, and no significant difference in femoral neck width. Logistic regression showed composite hip strength indices could predict hip fractures risk. To the same extent as FN BMD, Compression Strength Index (CSI) best predicted the risk for each fracture (AUC?=?0.787?±?0.028). When CSI was added to FN_BMD, there was a small but not statistically significant increase in AUC to 0.796?±?0.027 (P?=?0.9018).

Conclusion

Composite indices of femoral neck strength may be valuable in the assessment of the biomechanics of bone fragility; however, they do not appear to add diagnostic value to the simple measurement of BMD.     

加长螺旋刀片股骨抗旋髓内钉治疗股骨干合并同侧股骨颈骨折16例

目的 探讨加长螺旋刀片股骨抗旋髓内钉(proximal femoral nail antirotation,PFNA)治疗股骨干合并同侧股骨颈骨折的方法及手术治疗效果. 方法 回顾性分析2006 - 2009年通过加长PFNA治疗股骨干合并同侧股骨颈骨折16例随访患者的资料.致伤原因均为高能量损伤,其中交通伤11例,高处坠落伤5例.股骨颈骨折按照Garden分型:Ⅰ型7例,Ⅱ型6例,Ⅲ型3例.股骨干骨折包括上段6例,中段9例,下段1例.Winquist分型:Ⅰ型2例,Ⅱ型4例,Ⅲ型6例,Ⅳ型4例.开放性骨折2例,均为Gustilo - Anderson Ⅰ型.术后末次随访时通过Harris髋部评分评估功能恢复情况. 结果 随访时间1～4年,平均2.4年.股骨颈骨折平均愈合时间4.2个月(3～6个月),股骨干骨折平均愈合时间5.1个月(3～8个月).4例股骨颈骨折延迟诊断,2例股骨干骨折出现延迟愈合,1例发生股骨头缺血性坏死.1例患肢增长3 cm,伴膝关节活动痛4个月余.按Harris髋关节功能评分标准:优7例,良6例,中3例,优良率为82％.结论 股骨干合并同侧股骨颈骨折相对较少,股骨颈骨折的漏诊率较高,对于高能量损伤患者应提高警惕.加长PFNA符合生物学固定的特点,手术时间短且固定可靠,对股骨干合并同侧股骨颈骨折的治疗效果肯定.     

防旋股骨近端髓内钉治疗骨质疏松性股骨转子间骨折

目的 探讨防旋股骨近端髓内钉(proximal femoral nail anti-rotation,PFNA)治疗骨质疏松性股骨转子间骨折的初期疗效. 方法 2006年3月-2007年8月,采用PFNA和Gamma钉内固定治疗31例骨质疏松性股骨转子间骨折患者,男19例,女12例;年龄45～89岁,平均75.6岁.骨折按AO分类标准:A1型8例,A2型16例,A3型7例;按Evans-Jensen分型:Ⅱ18例,Ⅲ13例.均为闭合性骨折,其中有6例合并内科疾病.12例PFNA固定患者均经牵引、闭合复位,术中不显露骨折区域,小切口置钉. 结果 31例中,6例行急诊手术,19例在3 d内手术,6例待内科疾病控制后行择期手术(5～7 d).,PFNA治疗的手术时间、术中出血量、骨折愈合时间等较Gamma钉短或少(P＜0.05).所有患者均无感染、骨不连及内固定失效等并发症发生.根据Harris髋关节功能评分:PFNA优良率83%,Gamma钉优良率74%. 结论 PFNA治疗骨质疏松性股骨转子间骨折的疗效好,具有内固定可靠、创伤小、操作简单、手术时间及出血少、骨量丢失少、允许早期功能锻炼等优点,是治疗骨质疏松件股骨转子间骨折较为理想的髓内固定系统.     

Geometry of proximal femur in the prediction of hip fracture in osteoporotic women

111 White post-menopausal women with hip fracture and 329 healthy controls were studied in order to determine whether proximal femur geometry predicts hip fracture and improves the discriminant ability of femoral neck bone mineral density (BMD) in elderly women. All subjects underwent dual X-ray photon absorptiometry (DXA) of the hip from which the femoral neck BMD, hip axis length, femoral neck width and femoral neck-shaft angle were measured. Fractured subjects had a lower femoral neck BMD, a longer hip axis length and a more valgus neck-shaft angle. The hip axis length correlated significantly with neck-shaft angle, femoral neck width and age. No significant correlation was found between neck-shaft angle and age. On standardized logistic regression, the hip axis length and the neck-shaft angle predicted fracture independently of BMD after correction for age, weight and femoral neck BMD. The femoral neck BMD significantly discriminated fractured subjects after correction for all potential confounders. The logistic models containing simultaneously one femoral geometric parameter and the neck BMD discriminated significantly better than those containing the same variables as single predictor. Our data suggest that hip axis length may play a role in fracture risk and supports a similar role for neck-shaft angle. Combining proximal femur geometric measurements and femoral neck BMD improved the discriminant ability of each measurement.     

Spinous process fractures in osteoporotic thoracolumbar vertebral fractures

Objectives

To evaluate the incidence and pattern of spinous process fractures (SPFs) in patients with osteoporotic compression fractures (OCFs) of the thoracolumbar spine.

Methods

Spinal MRI or CT of 398 female patients (age range 50–89 years, mean age 70 years) who had OCFs in the thoracolumbar spine were retrospectively reviewed. The incidence, location and imaging results for the SPFs were evaluated.

Results

Of the 398 patients who had thoracolumbar OCFs, 14 (3.5%) had SPF. In six patients with single compression fractures, the SPF occurred at the level just above the vertebral compression fracture. In six out of seven patients with multiple continuous compression fractures, the SPF occurred just one level above the uppermost level of the compression fracture. The remaining one patient who had thoracolumbar spinal fixation at T12–L2 with continuous compression fractures in T12–L5 had a SPF in L2. In one patient who had multiple compression fractures in discontinuous levels (fractures at T10 and L1, respectively), the SPF occurred at T12. The directions of the fractures were vertical or oblique vertical (perpendicular to the long axis of the spinous process) in all cases.

Conclusion

In the presence of an OCF in the thoracolumbar spine, a SPF was found in 3.5% of cases, and most of the fractures were located just one level above the compression fracture. Therefore, in patients who have OCF, the possibility of a SPF in the level just above the compression fracture should be considered.Osteoporosis is a common disease owing to an increase in the population of older people. Osteoporosis is a disease that induces bone fragility, caused by a decrease in trabecular bone, and the resulting fracture is called an insufficiency fracture. The most common osteoporotic compression fractures occur in the spine, sacrum, pubis, femoral neck and wrist [1].Although the most common methods for imaging vertebral fractures are still spinal radiographs, benign spinal compression fractures are commonly detected by MRI or CT on osteoporotic patients with back pain. Sometimes, it is difficult to differentiate a benign spinal compression fracture from a malignant cause of the spinal compression fracture. However, in most cases, a benign spinal compression fracture shows some specific features: a low-signal-intensity band on T₁ and T₂ weighted images, spared normal bone marrow signal intensity of the vertebral body, retropulsion of a posterior bone fragment and multiple compression fractures [2]. A relationship between osteoporosis and benign spinal compression fractures, including insufficiency fractures, has been reported. A study examining the relationship between benign compression fractures of the spine and insufficiency fractures of the sacrum has also been reported [3]. However, there have been few reports of spinous process fractures in the osteoporotic spine [4]. Moreover, there have been no studies examining the relationship between spinous process fractures and benign compression fractures of the spine.We have noted index cases of spinous process fractures in certain patients with osteoporotic compression fractures. There has been no report of spinous process fractures in patients with osteoporotic compression fractures. The aim of this study was, therefore, to evaluate the relationship between osteoporotic compression fractures and spinous process fractures in patients with osteoporosis.     

Are patients with fractures of the femoral neck more osteoporotic?

Combined cancellous/cortical density and mass in the femur and lumbar spine were assessed 2 or 3 days after femoral neck fractures and compared to identical measurements in control subjects. Cancellous density was also assessed in the spine. Correction for age differences between patients and controls were made by means of regression analyses and by selecting groups without age differences. After compensation for the age differences, the patients were found to have significantly lower femoral bone mass and lumbar density than the controls. The femoral density and lumbar mass density were not significantly different in the two groups after age correction. The findings for the cancellous spinal density was equivocal. The study indicates that in the femur the total bone mineral content is lower in patients with femur neck fractures and that it is at least one of the etiological factors of these fractures. However, in the femur it is not the bone density that is the decisive factor, but the amount of calcified bone, or the bone mass.     

股骨近端防旋髓内钉治疗老年骨质疏松性股骨粗隆间骨折的疗效分析

采用股骨近端防旋髓内钉（PFNA）治疗骨质疏松性股骨粗隆间骨折86例,其中随访65例,时间12～36个月。无死亡病例,无伤口感染、螺旋刀片切出股骨头、髋内外翻等并发症,9例术后诉患侧臀部和大粗隆区疼痛。髋关节功能按Ha而s评分标准评价,优39例,良18例,可8例;优良率87．7％。     

Height gain of vertebral bodies and stabilization of vertebral geometry over one year after vertebroplasty of osteoporotic vertebral fractures

The height gain of vertebral bodies after vertebroplasty and geometrical stability was evaluated over a one-year period. Osteoporotic fractures were treated with vertebroplasty. The vertebral geometry and disc spaces were analysed using reformatted computed tomography (CT) images: heights of the anterior, posterior, and lateral vertebral walls, disc spaces, endplate angles, and minimal endplate distances. Vertebrae were assigned to group I [severe compression (anterior height/posterior height) <0.75] and group II (moderate compression index >0.75). A total of 102 vertebral bodies in 40 patients (12 men, 28 women, age 70.3 ± 9.5) were treated with vertebroplasty and prospectively followed for 12 months. Group I showed a greater benefit compared with group II with respect to anterior height gain (+2.1 ± 1.9 vs +0.7 ± 1.6 mm, P < 0.001), reduction of endplate angle (−3.6 ± 4.2 vs −0.8 ± 2.3°, P < 0.001), and compression index (+0.09 ± 0.11 vs +0.01 ± 0.06, P < 0.001). At one-year follow-up, group I demonstrated preserved anterior height gain (+1.5 ± 2.8 mm, P < 0.015) and improved endplate angle (−3.4 ± 4.9°, P < 0.001). In group II, the vertebral heights returned to and were fixed at the pre-interventional levels. Vertebroplasty provided vertebral height gain over one year, particularly in cases with severe compression. Vertebrae with moderate compression were fixed and stabilized at the pre-treatment level over one year.     

New symptomatic vertebral compression fractures within a year following vertebroplasty in osteoporotic women

BACKGROUND AND PURPOSE: Percutaneous vertebroplasty has been performed in the United States in an increasing volume since the mid-1990s. The purpose of this study is to analyze the risk of a new symptomatic vertebral compression fractures within 1 year of having an acute/subacute fracture treated with vertebroplasty. METHODS: A retrospective analysis was performed in which 253 female patients were found to have acute/subacute vertebral compression fractures secondary to osteoporosis treated with percutaneous vertebroplasty. Occurrences of new symptomatic vertebral compression fractures were recorded for a year following initial vertebroplasty. RESULTS: Fifty-five patients (21.7%) of the 253 osteoporotic women with one or more initial fractures experienced a new symptomatic vertebral compression fracture within 1 year. CONCLUSION: Roughly one-fifth of osteoporotic women with acute/subacute fracture treated with vertebroplasty will have a subsequent fracture within 1 year.     

骨质疏松老年妇女股骨近端16层螺旋CT的定量研究

目的:通过16层螺旋CT中vQCT技术对骨质疏松性椎体骨折及无骨折老年妇女股骨近端进行多个容积性BMD指标的测量,比较两组妇女股骨近端小梁骨、皮质骨和整体骨容积性BMD的差异,评价骨质疏松性椎体骨折对股骨近端骨密度的影响程度。方法:将26例骨质疏松性椎体骨折病人归为第一组,年龄与第一组匹配的无脊椎骨折的30例骨质疏松老年妇女归为第二组。应用GE公司LightSpeed16型螺旋CT对56例病人股骨近端行容积扫描,行薄层重建图像,层厚1·25mm,在3D-VR影像中沿左股骨颈长轴方向确定数个与之相垂直的平面作为固定的解剖学标记,选取左侧股骨近端整体骨、股骨颈及粗隆间测量兴趣体积(VOI),经SunADW4·0计算机工作站直方图(histogram)功能测量左侧股骨颈3D小梁骨BMD(N-TRAB)、3D整体骨BMD(N-INTGL),左侧粗隆间3D小梁骨BMD(T-TRAB)、3D整体骨BMD(T-INTGL),左侧股骨近端3D小梁骨BMD(FEM-TRAB)、3D皮质骨BMD(FEM-CORT)和3D整体骨BMD(FEM-INTGL)值。所有病人双能X线吸收仪(GE-Lunar公司DPX型)测量指标为左侧股骨颈(NECK)及粗隆间BMD(TROCH)。比较两组老年妇女间9项BMD指标差异采用协方差分析。结果:两组老年妇女间股骨近端容积性BMD数值除FEM-CORT一项指标外其差异存在统计学意义,在调节年龄和体型因素后仍然在差异,第一组老年妇女比第二组容积性BMD值下降程度为14%~18%,且vQCT技术中股骨近端容积性BMD的测量精度较高;两组间DXA指标中BMD值的差异在调节年龄和体型因素后无统计学意义:在TTRAB指标中第一组老年妇女比第二组的BMD值下降幅度达17·7%,高于N-TRAB中BMD值的下降度14·3%。结论:首次应用16层螺旋CT进行股骨近端vQCT测量,证实此项技术比DXA更全面地反应骨质疏松性椎体骨折比无骨折老年妇女股骨近端骨密度的下降状况,且不受体型大小和骨形态变化因素的影响。     

球囊后凸成形术治疗骨质疏松椎体压缩性骨折

目的 探讨球囊后凸成形术对骨质疏松椎体压缩性骨折的疗效.方法 回顾性随访2005～2007年采用经皮球囊后凸椎体成形术治疗老年人骨质疏松椎体压缩性骨折27例,43个椎体,测量术前术后骨折椎体的后凸角度,采用视觉模拟评分(VAS)比较患者术前和术后的疼痛变化.结果 本组病例均能耐受该手术,有5个椎体出现轻度骨水泥渗漏,但患者没有临床症状.术前术后脊柱X线片显示椎体高度有所恢复,脊柱后凸畸形改善,术前椎体后凸角度(19.7±7.2)°,术后(11.6±5.3)°,所有患者疼痛明显缓解,疼痛视觉模拟评分由术前8.0±1.3下降至术后3.7±1.5.结论 球囊后凸成形术能够有效地控制骨折疏松椎体压缩性骨折导致的疼痛,并可以部分恢复椎体高度和脊柱后凸畸形,有利于改善脊柱的功能,提高患者的生活质量.     

Latent mobility of osteoporotic vertebral compression fractures

PURPOSE: To describe the property of latent mobility in osteoporotic vertebral compression fractures (VCFs) and discuss its clinical significance. MATERIALS AND METHODS: This was a retrospective case series of 14 patients with 14 painful osteoporotic VCFs who were comfortably confined to the supine position overnight for the purpose of vertebral height restoration. There was sufficient additional vertebral height restoration the following morning to allow percutaneous vertebroplasty (PV) in some patients when this had initially been deemed unsafe or technically impossible. Anterior vertebral height of the index VCF was measured from the preoperative standing lateral, immediate cross-table supine lateral, and postconfinement cross-table supine lateral radiographs as well as the first postoperative standing lateral radiograph. Dynamic mobility was defined as the difference in anterior vertebral height between preoperative standing lateral and immediate cross-table supine lateral radiographs. Latent mobility was defined as difference in anterior vertebral height between immediate cross-table supine lateral and postconfinement cross-table supine lateral radiographs. Postoperative vertebral height restoration was defined as the difference in anterior vertebral height between preoperative and first postoperative standing lateral radiographs. Mean patient age was 81.0 years, and mean fracture age was 83.6 days. RESULTS: Dynamic mobility averaged +4.7 mm (range, -2.1 to +12.6 mm; P = .001). Latent mobility averaged +2.7 mm (range, -1.9 to +15.5; P < .02). The average sum of preoperative dynamic and latent mobility (+7.4 mm; range -1.0 to +17.0; P < .001) was not different from final postoperative vertebral height restoration (P > .4). PV was successfully accomplished in all cases. CONCLUSIONS: Latent mobility occurs in some VCFs and contributes to vertebral height restoration. Recognition of latent mobility may permit vertebroplasty in some patients in whom the procedure had otherwise been deemed unsafe. Reports of vertebral height restoration following vertebral augmentation should account for that proportion resulting from dynamic and latent mobility.     

女性髋部骨质疏松性骨折患者股骨近端几何结构对患者骨折危险的影响

目的研究女性髋部骨质疏松性骨折患者股骨近端几何结构对患者骨折危险的影响,以及股骨近端几何结构是否是独立于骨密度之外与髋骨骨折密切相关的危险因素。方法 2013年5月—2016年7月延安市人民医院骨科收治171例65周岁以上髋部骨质疏松性骨折女性患者(试验组,其中股骨颈骨折97例,股骨粗隆间骨折74例),另在同时期门诊收治65周岁以上骨质疏松症女性患者386例(对照组),采用双能X线吸收分析技术(DXA)分析比较这两组患者的骨密度(BMD)差异,并分析股骨近端几何结构与两种髋骨骨折之间的相关性。结果两组的体重、股骨颈横截面积(CSA)、股骨颈长(NL)、股骨颈宽与股骨近端骨密度差异有统计学意义(P0.05)。其中对照组股骨近端骨密度比试验组高(P0.05)。此外,在股骨颈骨折组中,股骨颈横截面积与股骨颈长骨折的比值比(OR)分别降低了1.98和1.72倍,而股骨颈宽骨折的OR增加了1.52倍;在粗隆间骨折组中,股骨颈宽骨折的OR则增加了1.44倍(P0.05),并且这些OR与股骨近端骨密度没有相关性。结论股骨颈宽是除骨密度以外独立的与女性髋骨骨折密切相关的危险因素。     

Quantitative ultrasound of the phalanges and DXA of the lumbar spine and proximal femur in evaluating the risk of osteoporotic vertebral fracture in postmenopausal women

Purpose

This study was undertaken to compare the quantitative ultrasound (QUS) parameters of amplitudedependent speed of sound (AD-SoS) and ultrasound bone profile index (UBPI) of the phalanges with bone mineral density (BMD) of the lumbar spine and proximal hip using dual-energy X-ray absorptiometry (DXA) in discriminating women with vertebral fracture.

Materials and methods

A total of 692 postmenopausal Caucasian women were included in the study. The presence of vertebral fracture was evaluated by radiography. AD-SoS and UBPI were measured at the phalangeal metaphysis using a DBM Sonic device. Multiple logistic regression analysis was performed to estimate the odds ratio (OR) for vertebral fractures. The ORs were also adjusted for the significant anthropometric variables of age, weight and height. Furthermore, for QUS parameters, the ORs were also adjusted for lumbar spine and total hip BMD.

Results

All measurements obtained with DXA and QUS significantly discriminated between women with and without fractures (p<0.0001). However, the OR was higher for lumbar spine BMD (OR 4.01), AD-SoS (OR 3.81), total hip (OR 3.7) and femoral neck BMD (OR 3.62).

Conclusions

The QUS parameter AD-SoS showed diagnostic sensitivity equal to that of lumbar DXA in discriminating between women with and without osteoporotic vertebral fractures.     

99Tcm-MDP SPECT/CT骨显像在绝经后女性骨质疏松性胸腰椎椎体骨折中的增益价值

目的研究99Tcm-MDP SPECT/CT骨显像及其半定量分析指标在绝经后女性骨质疏松性胸腰椎椎体骨折中的增益价值。 方法回顾性分析2012年11月至2016年10月因轻微外伤或日常活动导致胸腰背部疼痛而就诊,最终诊断为骨质疏松性胸腰椎椎体压缩性骨折的绝经后女性患者81例。选取SPECT/CT矢状位融合断层图像,利用ROI技术重复勾画病灶椎体（T）及与其相邻的正常椎体（NT）,并计算病灶椎体与正常椎体的放射性计数比值,即T/NT值。将所收集病例根据椎体是否在99Tcm-MDP SPECT/CT骨显像后进行手术分成两组,一组为手术组,包括行经皮穿刺椎体成形术及椎体球囊后凸成形术的患者,另一组为非手术组。对两组T/NT值采用两独立样本t检验进行统计学分析。 结果（1）手术组共计110个椎体,T/NT值为2.44±0.84;非手术组共计70个椎体,T/NT值为1.04±0.14,两组T/NT值的差异有统计学意义（t=13.654,P < 0.05）。（2）发现椎体以外骨折,包括肋骨骨折29例、椎体附件骨折2例、骶骨骨折2例、耻骨骨折1例。 结论99Tcm-MDP SPECT/CT骨显像及其半定量分析指标在指导绝经后女性骨质疏松性胸腰椎椎体压缩性骨折临床治疗方案的选择和其他部位是否有骨折的诊断中具有一定的参考价值。     

经皮椎体成形术治疗骨质疏松性椎体骨折疗效观察

目的探讨经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的临床疗效及应用价值。方法36例骨质疏松性压缩性骨折患者45个椎体，在C型臂X线透视下，取俯卧位，经皮穿刺，在病椎注入聚甲基丙烯酸甲酯。术前及术后3d进行疼痛视觉类比评分（VAS评分），并进行统计学分析。结果治疗后36例患者疼痛较治疗前有明显好转，VAS评分差异有统计学意义（P〈0．001）；活动能力也有不同程度改善；部分椎体的前缘和椎体中部高度有一定恢复。结论经皮椎体成形术治疗骨质疏松性椎体压缩骨折止痛效果明显，能很快改善患者的活动能力，早期下床活动。该手术属微创手术，在骨科临床有一定的应用前景。     

Under-reporting of osteoporotic vertebral fractures on computed tomography

Purpose

Osteoporotic vertebral fractures are frequently asymptomatic. They are often not diagnosed clinically or radiologically. Despite this, prevalent osteoporotic vertebral fractures predict future osteoporotic fractures and are associated with increased mortality and morbidity. Appropriate management of osteoporosis can reduce future fracture risk. Fractures on lateral chest radiographs taken for other conditions are frequently overlooked by radiologists. Our aim was to assess the value of computed tomography (CT) in the diagnosis of vertebral fracture and identify the frequency with which significant fractures are missed.

Materials and methods

The thoracic CT scans of 100 consecutive male and 100 consecutive female patients over 55 years were reviewed. CT images were acquired on General Electric Lightspeed multi-detector (MD) CT scanners (16 or 32 row) using 1.25 mm slice thickness. Midline sagittal images were reconstructed from the 3D volume images. The presence of moderate (25–40% height loss) or severe (>40% height loss) vertebral fractures between T1 and L1 was determined using an established semi-quantitative method and confirmed by morphological measurement. Results were compared with the formal CT report.

Results

Scans of 192 patients were analysed (95 female; 97 male); mean age 70.1 years. Thirty-eight (19.8%) patients had one or more moderate to severe vertebral fractures. Only 5 (13%) were correctly reported as having osteoporotic fractures in the official report. The sensitivity of axial CT images to vertebral fracture was 0.35.

Conclusion

Incidental osteoporotic vertebral fractures are under-reported on CT. The sensitivity of axial images in detecting these fractures is poor. Sagittal reformations are strongly recommended to improve the detection rate.     

经皮椎体成形术在多节段椎体骨折中的应用

目的探讨经皮椎体成形术(PVP)治疗多节段骨质疏松性椎体压缩骨折的安全性及疗效。方法回顾性分析PVP治疗骨质疏松性椎体压缩骨折患者86例,其中23例患者为多节段椎体骨折。分析患者术前、术中、术后的临床及影像学资料。采用模拟视觉评分(VAS)及Oswesty功能障碍指数(ODI)评价术后疼痛缓解及日常活动功能恢复情况。结果19例患者一次手术完成3节椎体,4例患者一次手术完成4节椎体。3例患者术中出现一过性血压升高和呼吸困难。术前VAS评分及ODI值平均8.58±1.12、81.43±12.54,术后1d平均为3.03±0.98、31.04±11.11,疼痛缓解及日常活动功能恢复显著。5例患者1年内出现再发椎体压缩骨折。13节椎体发生骨水泥外漏。结论PVP是治疗多节段骨质疏松性椎体压缩骨折安全、有效的方法。必须注意脂肪栓塞并发症,一次手术至多完成3节椎体。