骨质疏松症背景下胸椎和腰椎体压缩性骨折的经皮椎体成形术效果分析

Andrii Popov, Mykyta Moloduk
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Methods. 553 patients who underwent hospital treatment at the spine pathology clinic of the Sytenko Institute of Spine and Joint Pathology (2005–2022) and underwent PV were examined. Results. The patients were divided into three groups depending on the number of damaged vertebrae. The 1st group included the patients with compression fractures of one vertebra (185 — 33.4 %); the 2nd group included the patients having 2 or 3 deformed vertebrae (216 — 39 %); and the 3rd group included the patients with 4–5 damaged vertebrae (152 — 27.4 %). Stages of compression of vertebral bodies during the X-ray morphometry was as follows before the surgery: I — 349 (24 %) vertebrae; II — 494 (34 %); III — 552 (38 %); and IV — 58 (4 %). We achieved the reduction of the level of compression of vertebral bodies as a result of PV in 20 % of cases (patients who noticed the manifestation of the pain syndrome within 2 weeks mostly suffered from these deformations). Conclusions. 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摘要

众所周知,骨质疏松症最常见的并发症是椎体压缩性骨折。除了骨骼脆性和机械应力外,越来越多的证据表明,椎体压缩性骨折与许多危险因素有关,如年龄、性别、心脑血管疾病并发症和生活方式(长期吸烟和饮酒)。研究目的分析经皮椎体成形术(PV)后骨质疏松症背景下椎体压缩性骨折患者的脊柱状况。研究方法对 2005-2022 年间在 Sytenko 脊柱与关节病理研究所脊柱病理诊所接受住院治疗并接受经皮椎体成形术的 553 名患者进行了检查。结果如下根据受损椎骨的数量,患者被分为三组。第一组包括一个椎体压缩骨折的患者(185 - 33.4 %);第二组包括有 2 或 3 个畸形椎体的患者(216 - 39 %);第三组包括有 4-5 个受损椎体的患者(152 - 27.4 %)。手术前,X 光形态测量中椎体受压的阶段如下:Ⅰ--349(24%)个椎体;Ⅱ--494(34%)个椎体;Ⅲ--552(38%)个椎体;Ⅳ--58(4%)个椎体。在 20% 的病例中,我们通过椎体后凸成形术减轻了椎体的压迫程度(2 周内发现疼痛综合征症状的患者大多会出现这些变形)。结论对 553 例使用复合材料和骨水泥进行椎体后凸成形术的近期和远期分析结果为我们提供了一个机会,说明这种手术治疗是一种高效、安全的治疗方法(尽管使用了不同的材料)。第一组 165 例患者中有 40 例(24%)、第二组 157 例患者中有 52 例(33%)、第三组 133 例患者中有 54 例(44%)被诊断为重复性压缩骨折。综上所述,我们应该注意到,患者发生的压缩性骨折越多,椎体其他变形进一步加重的风险就越高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
ANALYSIS OF THE RESULTS OF PERCUTANEOUS VERTEBROPLASTY OF COMPRESSION FRACTURES OF BODIES OF CHEST AND LUMBAR VERTEBRAE ON THE BACKGROUND OF OSTEOPOROSIS
It is well known that the most frequent complication of osteoporosis is compression fractures of vertebral bodies. In addition to brittleness of the bones and mechanical stress, more and more evidence approving that compression fractures of vertebral bodies are related to many risk factors, such as aging, sex, concomitant morbidities of cardiovascular and cerebrovascular diseases and lifestyle (chronic smoking and alcohol consumption) are collected. Objective. Analyzing the condition of spines of the patients suffering from compression fractures of vertebral bodies on the background of osteoporosis after the performed Percutaneous vertebroplasty (PV). Methods. 553 patients who underwent hospital treatment at the spine pathology clinic of the Sytenko Institute of Spine and Joint Pathology (2005–2022) and underwent PV were examined. Results. The patients were divided into three groups depending on the number of damaged vertebrae. The 1st group included the patients with compression fractures of one vertebra (185 — 33.4 %); the 2nd group included the patients having 2 or 3 deformed vertebrae (216 — 39 %); and the 3rd group included the patients with 4–5 damaged vertebrae (152 — 27.4 %). Stages of compression of vertebral bodies during the X-ray morphometry was as follows before the surgery: I — 349 (24 %) vertebrae; II — 494 (34 %); III — 552 (38 %); and IV — 58 (4 %). We achieved the reduction of the level of compression of vertebral bodies as a result of PV in 20 % of cases (patients who noticed the manifestation of the pain syndrome within 2 weeks mostly suffered from these deformations). Conclusions. The results of analysis of PV of 553 patients with composite material and bone cement in the near and far future provide us an opportunity to state that this surgical treatment is an efficient and safe treatment method (despite the materials used). 40 (24 %) patients out of 165 patients of the group I, 52 (33 %) patients out of 157 patients of the group II and 54 (44 %) patients our of 133 patients of the group III were diagnosed with repeated compression fractures. Summarizing all the above, we should note that the more compression fractures the patient has, the higher the risk of further augmentation of other deformations of vertebral bodies is.
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