MRI与DR成像在椎体后凸成形术治疗骨质疏松性椎体压缩骨折中价值

目的探讨磁共振及数字X线成像在椎体后凸成形术治疗单纯新鲜老年骨质疏松性椎体压缩性骨折(OVCF)中应用价值。方法回顾分析2009年11月至2012年3月经PKP治疗OVCF患者47例,其中22例患者术前、术后及术后3～6个月摄椎体正侧位平片,术前及术后3～6个月MRI检查。比较术前、术后椎体前缘、中央高度及Cobb角变化情况,末次随访椎体高度丢失情况;术中在C型臂X线透视下监测及术后椎体正侧位片上观察骨水泥渗漏及分布情况;末次随访时MRI及DR共同诊断邻近椎体再发骨折率。结果 22名患者均表现为单纯新鲜性压缩骨折,术前、术后椎体前缘、中央高度比较及Cobb角变化差异有统计学意义(P<0.05);末次随访椎体前缘、中央高度与术后相比,差异无统计学意义(P>0.05),术后24椎有3椎出现骨水泥渗漏;在随访中发现有两名患者出现邻近椎体新发骨折。结论影像学检查在PKP治疗OVCF中有重要意义。

Value of magnetic resonance imaging(MRI) versus digital radiography(DR)in new benign percutaneous kyphoplasty for the treatment of osteoporotic vertebral compressive fracture

Objective To explore the value of MRI and DR in PKP for the treatment of OVCFs.Methods The clinical data of 47 patients with osteoporotic vertebral new benign compressive fractures from Nov 2009 to Mar 2012 were retrospectively analyzed.Twenty-two of the patients(24 vertebral bodies) were treated with PKP,rather than have DR film(including X-ray film to Spine PA and LAT of preoperative,postoperative,and follow up from 3 to 6 months) and MRI(including preoperative,and follow up).The anterior vertebrae height,center vertebral height and vertebrae Cobb angle were measured in lumber spine preoperation,postoperative and follow up from 3 to 6 months.The height of improvement of damaged vertebral bodies and the height loss of damaged vertebral bodies during follow up,the change of vertebrae Cobb angle were explored.The ration of bone cement leakage in operation and distributional pattern were observed by bilateral vertebral arch under X-ray.The fracture of adjacent vertebrae at the last follow up was diagnosed by MRI and X-ray.Results The recovery of anterior vertebrae height,center vertebrae height,vertebrae Cobb angle between peroperation and postoperation were significantly different.At the last follow up,the loss of damaged anterior vertebrae height and the center vertebrae height were not different compared to those of postoperation.Of 24 patients,3 complicated with bone cement leakage,and at the last follow-up,2 patients showed new fracture occurrence in adjacent vertebrae.Conclusion Imaging has certain value in PKP for the treatment of new benign OVCFs.