椎体强化术后骨水泥相对终板的位置对邻椎再骨折的影响

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Abstract Objective To explore the impact upon adjacent vertebrae fracture resulting from the position of bone-cement relative to surgical vertebrae and adjacent vertebrae endplates after percutaneous vertebroplasty(PVP) or percutaneous kyphoplasty (PKP).Methods The clinical data of 191 patients aging from 56 to 83 who received PVP or PKP from July 2013 to March 2017 because of osteoporotic vertebral compression fractures were retrospectively analyzed.The follow-up period was 20 monthsandthe average age of the patients was 69.8 years old.There were 202 surgical vertebrae，including 37 vertebrae of male patients and 165 vertebrae from female patients.According to the occurrence of adjacent vertebral fracture(AVF)，the patients were divided into two groups.The first group was AVF Group(n＝22)and the second group was non-AVF Group(n＝180).The age，gender，body mass index (BMI)，bone mineral density (BMD)，the contact rate of bone-cement endplates，the leakage rate of cement intervertebral disc and the distance between bone-cement and adjacent vertebral endplate in the two groups were compared.Results There was no significant difference in age，gender，BMI and BMD between the two groups (P＞0.05).The difference between the contact rate of bone-cement and surgical vertebra in the two groups was of no statistical significance(χ²=3.251，P＝0.071)，but the bone-cement intradiscal leak in the Group AVF was significantly higher than that in the group non-AVF and the difference was statistically significant(χ²=5.018，P＝0.025).The mean value of the distance between bone-cement and adjacent vertebral endplate in the Group AVF was (6.49±3.13)mm，while the distance in the Group non-AVF was(8.71±4.38)mm.The difference between the two groups was statistically significant(t＝2.307，P＝0.022).Conclusion The bone-cement intradiscal leakageis risk factor for adjacent vertebral fracture.The smaller distance of bone-boundary between adjacent endplate，the chance of occurring homolateral AVF is larger.The operators can choose different methods to adequately strengthen the surgical vertebrae or to guarantee safe distance between bone-cement and adjacent vertebral endplate according to the height of vertebrae before surgery.

Key words： adjacent vertebral fracture endplate contact intradiscal leak safe distance

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	Li Yajun 1
	Wang Yehua 1*
	Fang Yiling 2
	et al

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Li Yajun 1,Wang Yehua 1*,Fang Yiling 2, et al. Effect of Bone-cement Position Relative to Endplate after Vertebral Augmentationon Adjacent Vertebrae Fracture[J]. sygkzz, 2019, 25(9): 769-780.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2019/V25/I9/769

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