摘要
目的探讨MRI表现特征对经皮椎体后凸成形术选择靶椎体的指导作用。方法回顾性分析36例经皮椎体后凸成形术,根据术前MRI信号强度的改变将骨折椎体进行分类,通过观察患者手术前后压缩椎体前缘及中线高度恢复情况、局部Cobb角、VAS评分及Oswesty功能障碍指数变化情况来评估不同类型之间手术疗效的差异,进而总结MRI表现特征对经皮椎体后凸成形术选择靶椎体的标准。并利用这一选择方法前瞻性判断19例经皮椎体后凸成形术的靶椎体,根据患者手术前后VAS评分及Oswesty功能障碍指数变化情况来评估手术疗效。结果利用总结的经验选择经皮椎体后凸成形术的靶椎体,术后所有患者的疼痛症状均得到迅速而有效地缓解,随访时VAS评分改善率为(71.96±9.43)%,与回顾性研究改善率(67.44±17.57)%之间的差异无统计学意义,术后随访时Oswesty功能障碍指数改善率为(65.92±7.31)%,与回顾性研究改善率(66.51±6.39)%之间的差异也无统计学意义。结论MRI对经皮椎体后凸成形术选择靶椎体具有重要的指导作用。
Objective To explore the value of MRI in the evaluation of painful vertebrae to be treated by percutaneous kyphoplasty. Methods Thirty-six patients with 97 vertebral compression fractures were treated by PKP and were retrospectively analyzed. Based on changes in MRI signal intensity, all compression fractures were divided into 3 types. Types were examined for differences in treatment efficacy, which was assessed by the change in anterior/middle vertebral body height, Cobb＇s angle, visual analogue scale （VSA） and Oswesty disability index （ODI） before and after operations. The criterion for the choice of operative vertebrae with percutaneous kyphoplasty was explored.Nineteen cases were studied by prospective analysis. The operative vertebrae of each case were chosen by the summary criterion before operation. Efficacy was assessed by the mean change in VAS and ODI before and after operations.Results All the prospective eases had rapid and significant improvement in back pain following percutaneous kyphoplasty.The VAS and ODI showed significant difference pre- and post-operatively, and at the final follow-up. The improvement rate of VAS was （67.44±17.57）% for the retrospective case and （71.96±9.43）% for the prospective case, without statistical significance. The improvement rate of ODI was （66.51±6.39）% and （65.92± 7.31）% for the retrospective and prospective case respectively, also without statistical significance. Conclusion Painful vertebrae can be determined by MRI signal intensity changes and their selection for PKP can improve outcomes in patients with osteoporotic vertebral compression fractures.
出处
《中国骨与关节损伤杂志》
2009年第11期978-981,共4页
Chinese Journal of Bone and Joint Injury
关键词
MRI
经皮椎体后凸成形术
靶椎体
Magnetic resonance imaging
Percutaneous kyphoplasty
Operative vertebrae
