摘要
目的探讨HU值对于椎体成形术后非暴力新发椎体骨折的预测价值,为降低经皮椎体成形术(percutaneous vertebroplasty,PVP)后新发椎体骨折及再入院提供参考。方法回顾性分析2016年1月至2021年9月,在本院行PVP治疗的98例椎体压缩性骨折患者的临床及影像学资料,以术后是否出现新发椎体骨折分组:新发骨折组(PVP术后因非暴力因素新发椎体压缩骨折患者,n=24)和未骨折组(PVP术后2年随访期间未发生椎体压缩性骨折患者,n=74)。对比两组初次手术时年龄、性别、外伤史、骨折椎体位置、PVP椎弓根穿刺部位、初次手术骨水泥填充量。测量并比较两组患者椎体HU值,并采用ROC曲线分析PVP术后再骨折椎体的临界HU值。结果两组患者年龄、性别、外伤史、骨折椎体位置、PVP椎弓根穿刺部位差异无统计学意义(P>0.05)。在骨水泥填充量方面,新发骨折组患者首次骨水泥填充量差异有统计学意义(P=0.014),填充4 ml骨水泥患者较多。新发骨折组患者椎体HU平均值为52.47±25.78,未骨折组患者椎体HU平均值为75.38±31.99,差异有统计学意义(t=-3.156,P=0.002),ROC曲线显示新发椎体患者椎体松质骨的临界HU值为60.5。结论椎体松质骨HU值对PVP术后新发椎体骨折有潜在预测价值,对于HU值低于60.5的患者围术期建议采用严格的抗骨质疏松治疗。
Objective To explore the predictive value of the Hounsfield units(HU)value for the nonviolent fracture of the new vertebral body after percutaneous vertebroplasty(PVP),and further to reduce the new fracture and re-admission after PVP.Methods The clinical and imaging data of the patients with compression fracture of the vertebral body was analyzed retrospectively from January 2016 to September 2021.All 98 cases were divided into two groups based on the fracture of new vertebral body:the new-fracture group(24 cases with vertebral compression fracture due to non-violent factors after PVP)and the non-fracture group(74 cases without vertebral compression fracture during the 2-year follow-up after PVP).The age,gender,trauma history,fracture position,PVP pedicle puncture site,amount of bone cement in the primary operation and HU values were recorded and compared between the two groups.ROC curve was used to analyze the critical HU values of the new fractured vertebra after PVP.Results There were no statistically significant differences in the age,gender,trauma history,fracture position and PVP pedicle puncture site(P>0.05).In terms of the amount of bone cement filled,there was a statistical difference in the amount of bone cement filled for the first time in the new-fracture group.Most of the patients were filled with 4ml bone cement during the first operation.Statistical differences were observed in HU value between the two group(new-fracture group,52.47±25.78;non-fracture group,75.38±31.99;t=-3.156,P=0.002).ROC curve showed that the critical HU values of the cancellous bone of the vertebral body in patients with new fracture was 60.5.Conclusions HU value of the vertebral cancellous bone has potential predictive value for the refracture of new vertebral body after PVP,and strict perioperative anti-osteoporosis treatment is recommended for patients with HU value lower than 60.5.
作者
杨浦鑫
王辉
徐佳欣
许星柱
刘庆涛
丁文元
YANG Pu-xin;WANG Hui;XU Jia-xin;XU Xing-zhu;LIU Qing-tao;DING Wen-yuan(Department of Spinal Surgery,The Third Hospital of Hebei Medical University,Shijiazhuang,Hebei,050051,China)
出处
《中国骨与关节杂志》
CAS
2023年第4期266-270,共5页
Chinese Journal of Bone and Joint
基金
河北省自然科学基金(H2022206056)。
