椎体增强术后继发骨折的研究进展
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摘要
椎体增强术(percutaneous vertebral augmentation,PVA)是治疗椎体压缩性骨折最常用的微创手术方法,其创伤小、临床效果确切。PVA手术可导致病椎和邻椎继发骨折,其原因有病椎生物力学改变、骨水泥渗漏及骨密度等因素,本文将对PVA术后继发骨折的原因和预防措施进行分析,为今后的临床工作提供参考。
Percutaneous vertebral augmentation(PVA)is the most commonly used minimally invasive surgical method for the treatment of vertebral compressive fracture,while it may lead to secondary fracture of diseased vertebra and adjacent vertebra.The causes of secondary fracture after PVA are related to the biomechanical changes of vertebra,bone cement leakage and bone density,etc.Related studies on secondary fracture after PVA surgery are summarized in this review.
Percutaneous vertebral augmentation(PVA)is the most commonly used minimally invasive surgical method for the treatment of vertebral compressive fracture,while it may lead to secondary fracture of diseased vertebra and adjacent vertebra.The causes of secondary fracture after PVA are related to the biomechanical changes of vertebra,bone cement leakage and bone density,etc.Related studies on secondary fracture after PVA surgery are summarized in this review.
引文
1余鹏,夏群,皮红林,等.经皮椎体成形术后相邻椎体再骨折的相关因素[J].中华创伤杂志,2013,29(11):1063-1067.
2 Li YA,Lin CL,Chang MC,et al.Subsequent vertebral fracture after vertebroplasty:incidence and analysis of risk factors[J].Spine(Phila Pa 1976),2012,37(3):179-183.
3 Nouda S,Tomita S,Kin A,et al.Adjacent vertebral body fracture following vertebroplasty with polymethylmethacrylate or calcium phosphate cement:biomechanical evaluation of the cadaveric spine[J].Spine(Phila Pa 1976),2009,34(24):2613-2618.
4 Jacobson RE,Granville M,Hatgis J,et al.Low Volume Vertebral Augmentation with Cortoss(R)Cement for Treatment of High Degree Vertebral Compression Fractures and Vertebra Plana[J].Cureus,2017,9(2):e1058.
5 Gao C,Zong M,Wang WT,et al.Analysis of risk factors causing short-term cement leakages and long-term complications after percutaneous kyphoplasty for osteoporotic vertebral compression fractures[J].Acta Radiol,2018,59(5):577-585.
6 Zhong BY,He SC,Zhu HD,et al.Risk Prediction of New Adjacent Vertebral Fractures After PVP for Patients with Vertebral Compression Fractures:Development of a Prediction Model[J].Cardiovasc Intervent Radiol,2017,40(2):277-284.
7 Ko BS,Cho KJ,Park JW.Early Adjacent Vertebral Fractures after Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures[J].Asian Spine J,2019,13(2):210-215.
8 Ren HL,Jiang JM,Chen JT,et al.Risk factors of new symptomatic vertebral compression fractures in osteoporotic patients undergone percutaneous vertebroplasty[J].Eur Spine J,2015,24(4):750-758.
9刘波.胰岛素抵抗与骨质疏松椎体性压缩骨折椎体成形术后新发骨折风险的相关性研究[D].泸州:西南医科大学,2018.
10 Kim JM,Shin DA,Byun DH,et al.Effect of bone cement volume and stiffness on occurrences of adjacent vertebral fractures after vertebroplasty[J].J Korean Neurosurg Soc,2012,52(5):435-440.
11 Lin D,Hao J,Li L,et al.Effect of Bone Cement Volume Fraction on Adjacent Vertebral Fractures After Unilateral Percutaneous Kyphoplasty[J].Clin Spine Surg,2017,30(3):E270-e275.
12 Seo DH,Oh SH,Yoon KW,et al.Risk Factors of New Adjacent Compression Fracture after Percutaneous Vertebroplasty:Effectiveness of Bisphosphonate in Osteoporotic or Osteopenic Elderly Patients[J].Korean J Neurotrauma,2014,10(2):86-91.
13任海龙.椎体成形术治疗骨质疏松性椎体压缩骨折的临床及生物力学研究[D].广州:南方医科大学,2017.
14 Cyteval C,Thomas E,Solignac D,et al.Prospective evaluation of fracture risk in osteoporotic patients after low cement volume vertebroplasty[J].J Radiol,2008,89(6):797-801.
15 Fu ZZ,Chen ZX,Qin Y,et al.Low cement distribution index is a risk factor for refracture of the adjacent segments after percutaneous vertebroplasty[J].Nan Fang Yi Ke Da Xue Xue Bao,2017,37(7):947-951.
16吴钊钿,陈荣彬,李勇,等.骨水泥弥散类型与椎体强化术后再发术椎塌陷的相关性分析[J].中国医药导报,2018,15(27):62-65.
17钟远鸣,付拴虎,张家立,等.骨质疏松脊柱压缩性骨折经皮穿刺椎体成形术后再骨折因素的临床研究[J].中国矫形外科杂志,2013,21(18):1829-1832.
18 Bae JS,Park JH,Kim KJ,et al.Analysis of Risk Factors for Secondary New Vertebral Compression Fracture Following Percutaneous Vertebroplasty in Patients with Osteoporosis[J].World Neurosurg,2017,99:387-394.
19何奇龙,陈荣彬,李勇.骨水泥的弥散情况对经皮椎体成形的疗效影响[J].中国中医骨伤科杂志,2018,26(6):51-55.
20张大鹏,毛克亚,强晓军,等.椎体增强术后骨水泥分布形态分型及其临床意义[J].中华创伤杂志,2018,34(2):130-137.
21 Lee JH,Lee DO,Lee JH,et al.Comparison of radiological and clinical results of balloon kyphoplasty according to anterior height loss in the osteoporotic vertebral fracture[J].Spine J,2014,14(10):2281-2289.
22刘东光,周辉,金永明,等.骨质疏松性椎体压缩骨折PVP术后相邻椎体骨折的相关因素分析[J].中国脊柱脊髓杂志,2010,20(12):980-984.
23 Lin WC,Chen HL,Lu CH,et al.Dynamic contrast-enhanced magnetic resonance imaging for evaluating intraosseous cleft formation in patients with osteoporotic vertebral compression fractures before vertebroplasty[J].Spine(Phila Pa 1976),2011,36(15):1244-1250.
24 Jacobson RE,Palea O,Granville M.Progression of Vertebral Compression Fractures After Previous Vertebral Augmentation:Technical Reasons for Recurrent Fractures in a Previously Treated Vertebra[J].Cureus,2017,9(10):e1776.
25 Nieuwenhuijse MJ,Van Erkel AR,Dijkstra PD.Cement leakage in percutaneous vertebroplasty for osteoporotic vertebral compression fractures:identification of risk factors[J].Spine J,2011,11(9):839-848.
26 Qian J,Yang H,Jing J,et al.The early stage adjacent disc degeneration after percutaneous vertebroplasty and kyphoplasty in the treatment of osteoporotic VCFs[J].PLoS One,2012,7(10):e46323.
27 Kosmopoulos V,Keller TS,Schizas C.Early stage disc degeneration does not have an appreciable affect on stiffness and load transfer following vertebroplasty and kyphoplasty[J].Eur Spine J,2009,18(1):59-68.
28张林林.椎间盘退变与椎体级联骨折相关性的研究[D].苏州:苏州大学,2017.
29 Sun G,Tang H,Li M,et al.Analysis of risk factors of subsequent fractures after vertebroplasty[J].Eur Spine J,2014,23(6):1339-1345.
30 Lin WC,Cheng TT,Lee YC,et al.New vertebral osteoporotic compression fractures after percutaneous vertebroplasty:retrospective analysis of risk factors[J].J Vasc Interv Radiol,2008,19(2 Pt 1):225-231.
31李业成,张巍,张成亮,等.PVP术后相邻椎体新发骨折的危险因素分析[J].中国骨与关节损伤杂志,2017,32(1):25-27.
32 Lee HJ,Park J,Lee IW,et al.Clinical,Radiographic,and Morphometric Risk Factors for Adjacent and Remote Vertebral Compression Fractures Over a Minimum Follow-up of 4 Years After Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures:Novel Three-dimensional Voxel-Based Morphometric Analysis[J/OL].https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(19)30114-7.
33 Yang S,Liu Y,Yang H,et al.Risk factors and correlation of secondary adjacent vertebral compression fracture in percutaneous kyphoplasty[J].Int J Surg,2016,36(Pt A):138-142.
34 Ma X,Xing D,Ma J,et al.Risk factors for new vertebral compression fractures after percutaneous vertebroplasty:qualitative evidence synthesized from a systematic review[J].Spine(Phila Pa1976),2013,38(12):E713-722.
35 Hsu E,Nanes M.Advances in treatment of glucocorticoid-induced osteoporosis[J].Curr Opin Endocrinol Diabetes Obes,2017,24(6):411-417.
36 Rohlmann A,Pohl D,Bender A,et al.Activities of everyday life with high spinal loads[J].PLoS One,2014,9(5):e98510.
37 Cheng X,Long HQ,Xu JH,et al.Comparison of unilateral versus bilateral percutaneous kyphoplasty for the treatment of patients with osteoporosis vertebral compression fracture(OVCF):a systematic review and meta-analysis[J].Eur Spine J,2016,25(11):3439-3449.
38 Liebschner MA,Rosenberg WS,Keaveny TM.Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty[J].Spine(Phila Pa 1976),2001,26(14):1547-1554.
39 Jing Z,Dong J,Li Z,et al.Single balloon versus double balloon bipedicular kyphoplasty:a systematic review and meta-analysis[J].Eur Spine J,2018,27(10):2550-2564.
40杨航,彭成忠,曾庆虎,等.单双侧穿刺椎体成形术对邻近椎体再骨折影响的比较[J].生物骨科材料与临床研究,2018,15(5):41-44.
41 Liu J,Yu LJ,Song HP,et al.Analysis of correlative factors of non-surgical vertebral fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fractures[J].Zhongguo Gu Shang,2013,26(3):190-193.
42 Knavel EM,Rad AE,Thielen KR,et al.Clinical outcomes with hemivertebral filling during percutaneous vertebroplasty[J].AJNRAm J Neuroradiol,2009,30(3):496-499.
43林森,陈小强,周涛,等.骨质疏松性椎体压缩性骨折椎体成形术后再骨折的影响因素分析[J].中华临床医师杂志(电子版),2016,10(12):1670-1673.
44 Ning L,Wan S,Liu C,et al.New Levels of Vertebral Compression Fractures after Percutaneous Kyphoplasty:Retrospective Analysis of Styles and Risk Factors[J].Pain Physician,2015,18(6):565-572.
45 Wang H,Zhang Z,Liu Y,et al.Percutaneous kyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures with spinal canal compromise[J].J Orthop Surg Res,2018,13(1):13.
46 Zhiyong C,Yun T,Hui F,et al.Unilateral Versus Bilateral Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures:A Systematic Review of Overlapping Meta-analyses[J].Pain Physician,2019,22(1):15-28.
47钟睿,王润生,刘建恒,等.经皮椎体强化术不同入路方式综述[J].解放军医学院学报,2019,40(2):196-198.
48周权发,刘宏建,寇红伟,等.弯角椎体成形装置的早期疗效评估及对骨水泥分布的影响[J].中国矫形外科杂志,2017,25(10):892-897.
49熊森,毛克亚,韩振川,等.弯角输送装置在体外椎体成形实验中的效果观察[J].解放军医学院学报,2016,37(7):769-772.
50钟睿,姜威,熊森,等.单侧弯角与直行入路椎体成形治疗骨质疏松性椎体压缩骨折疗效的对照研究[J].中华创伤杂志,2018,34(2):102-108.
51李世梁,连育才,孙海东,等.骨水泥分布系数及骨水泥量与经皮椎体后凸成形术早期疗效相关性分析[J/OL].http://kns.cnki.net/kcms/detail/50.1097.R.20190129.1332.017.html.
52李如义,牟林,安建鹏,等.微创椎弓根螺钉内固定联合椎体成形术治疗胸腰椎骨质疏松性骨折[J].世界最新医学信息文摘,2018,18(58):29-30.
53包拥政,祝周兴,冯云升,等.低弹性模量骨水泥对骨质疏松压缩性骨折椎体及邻近椎体应力的影响:三维有限元分析[J].中国组织工程研究,2016,20(16):2285-2293.
54 Holub O,Lopez A,Borse V,et al.Biomechanics of low-modulus and standard acrylic bone cements in simulated vertebroplasty:A human ex vivo study[J].J Biomech,2015,48(12):3258-3266.
55 Kobayashi N,Numaguchi Y,Fuwa S,et al.Prophylactic vertebroplasty:cement injection into non-fractured vertebral bodies during percutaneous vertebroplasty[J].Acad Radiol,2009,16(2):136-143.
56 Kurutz M,Varga P,Jakab G.Prophylactic vertebroplasty versus kyphoplasty in osteoporosis:A comprehensive biomechanical matched-pair study by in vitro compressive testing[J].Med Eng Phys,2019,65:46-56.
2 Li YA,Lin CL,Chang MC,et al.Subsequent vertebral fracture after vertebroplasty:incidence and analysis of risk factors[J].Spine(Phila Pa 1976),2012,37(3):179-183.
3 Nouda S,Tomita S,Kin A,et al.Adjacent vertebral body fracture following vertebroplasty with polymethylmethacrylate or calcium phosphate cement:biomechanical evaluation of the cadaveric spine[J].Spine(Phila Pa 1976),2009,34(24):2613-2618.
4 Jacobson RE,Granville M,Hatgis J,et al.Low Volume Vertebral Augmentation with Cortoss(R)Cement for Treatment of High Degree Vertebral Compression Fractures and Vertebra Plana[J].Cureus,2017,9(2):e1058.
5 Gao C,Zong M,Wang WT,et al.Analysis of risk factors causing short-term cement leakages and long-term complications after percutaneous kyphoplasty for osteoporotic vertebral compression fractures[J].Acta Radiol,2018,59(5):577-585.
6 Zhong BY,He SC,Zhu HD,et al.Risk Prediction of New Adjacent Vertebral Fractures After PVP for Patients with Vertebral Compression Fractures:Development of a Prediction Model[J].Cardiovasc Intervent Radiol,2017,40(2):277-284.
7 Ko BS,Cho KJ,Park JW.Early Adjacent Vertebral Fractures after Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures[J].Asian Spine J,2019,13(2):210-215.
8 Ren HL,Jiang JM,Chen JT,et al.Risk factors of new symptomatic vertebral compression fractures in osteoporotic patients undergone percutaneous vertebroplasty[J].Eur Spine J,2015,24(4):750-758.
9刘波.胰岛素抵抗与骨质疏松椎体性压缩骨折椎体成形术后新发骨折风险的相关性研究[D].泸州:西南医科大学,2018.
10 Kim JM,Shin DA,Byun DH,et al.Effect of bone cement volume and stiffness on occurrences of adjacent vertebral fractures after vertebroplasty[J].J Korean Neurosurg Soc,2012,52(5):435-440.
11 Lin D,Hao J,Li L,et al.Effect of Bone Cement Volume Fraction on Adjacent Vertebral Fractures After Unilateral Percutaneous Kyphoplasty[J].Clin Spine Surg,2017,30(3):E270-e275.
12 Seo DH,Oh SH,Yoon KW,et al.Risk Factors of New Adjacent Compression Fracture after Percutaneous Vertebroplasty:Effectiveness of Bisphosphonate in Osteoporotic or Osteopenic Elderly Patients[J].Korean J Neurotrauma,2014,10(2):86-91.
13任海龙.椎体成形术治疗骨质疏松性椎体压缩骨折的临床及生物力学研究[D].广州:南方医科大学,2017.
14 Cyteval C,Thomas E,Solignac D,et al.Prospective evaluation of fracture risk in osteoporotic patients after low cement volume vertebroplasty[J].J Radiol,2008,89(6):797-801.
15 Fu ZZ,Chen ZX,Qin Y,et al.Low cement distribution index is a risk factor for refracture of the adjacent segments after percutaneous vertebroplasty[J].Nan Fang Yi Ke Da Xue Xue Bao,2017,37(7):947-951.
16吴钊钿,陈荣彬,李勇,等.骨水泥弥散类型与椎体强化术后再发术椎塌陷的相关性分析[J].中国医药导报,2018,15(27):62-65.
17钟远鸣,付拴虎,张家立,等.骨质疏松脊柱压缩性骨折经皮穿刺椎体成形术后再骨折因素的临床研究[J].中国矫形外科杂志,2013,21(18):1829-1832.
18 Bae JS,Park JH,Kim KJ,et al.Analysis of Risk Factors for Secondary New Vertebral Compression Fracture Following Percutaneous Vertebroplasty in Patients with Osteoporosis[J].World Neurosurg,2017,99:387-394.
19何奇龙,陈荣彬,李勇.骨水泥的弥散情况对经皮椎体成形的疗效影响[J].中国中医骨伤科杂志,2018,26(6):51-55.
20张大鹏,毛克亚,强晓军,等.椎体增强术后骨水泥分布形态分型及其临床意义[J].中华创伤杂志,2018,34(2):130-137.
21 Lee JH,Lee DO,Lee JH,et al.Comparison of radiological and clinical results of balloon kyphoplasty according to anterior height loss in the osteoporotic vertebral fracture[J].Spine J,2014,14(10):2281-2289.
22刘东光,周辉,金永明,等.骨质疏松性椎体压缩骨折PVP术后相邻椎体骨折的相关因素分析[J].中国脊柱脊髓杂志,2010,20(12):980-984.
23 Lin WC,Chen HL,Lu CH,et al.Dynamic contrast-enhanced magnetic resonance imaging for evaluating intraosseous cleft formation in patients with osteoporotic vertebral compression fractures before vertebroplasty[J].Spine(Phila Pa 1976),2011,36(15):1244-1250.
24 Jacobson RE,Palea O,Granville M.Progression of Vertebral Compression Fractures After Previous Vertebral Augmentation:Technical Reasons for Recurrent Fractures in a Previously Treated Vertebra[J].Cureus,2017,9(10):e1776.
25 Nieuwenhuijse MJ,Van Erkel AR,Dijkstra PD.Cement leakage in percutaneous vertebroplasty for osteoporotic vertebral compression fractures:identification of risk factors[J].Spine J,2011,11(9):839-848.
26 Qian J,Yang H,Jing J,et al.The early stage adjacent disc degeneration after percutaneous vertebroplasty and kyphoplasty in the treatment of osteoporotic VCFs[J].PLoS One,2012,7(10):e46323.
27 Kosmopoulos V,Keller TS,Schizas C.Early stage disc degeneration does not have an appreciable affect on stiffness and load transfer following vertebroplasty and kyphoplasty[J].Eur Spine J,2009,18(1):59-68.
28张林林.椎间盘退变与椎体级联骨折相关性的研究[D].苏州:苏州大学,2017.
29 Sun G,Tang H,Li M,et al.Analysis of risk factors of subsequent fractures after vertebroplasty[J].Eur Spine J,2014,23(6):1339-1345.
30 Lin WC,Cheng TT,Lee YC,et al.New vertebral osteoporotic compression fractures after percutaneous vertebroplasty:retrospective analysis of risk factors[J].J Vasc Interv Radiol,2008,19(2 Pt 1):225-231.
31李业成,张巍,张成亮,等.PVP术后相邻椎体新发骨折的危险因素分析[J].中国骨与关节损伤杂志,2017,32(1):25-27.
32 Lee HJ,Park J,Lee IW,et al.Clinical,Radiographic,and Morphometric Risk Factors for Adjacent and Remote Vertebral Compression Fractures Over a Minimum Follow-up of 4 Years After Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures:Novel Three-dimensional Voxel-Based Morphometric Analysis[J/OL].https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(19)30114-7.
33 Yang S,Liu Y,Yang H,et al.Risk factors and correlation of secondary adjacent vertebral compression fracture in percutaneous kyphoplasty[J].Int J Surg,2016,36(Pt A):138-142.
34 Ma X,Xing D,Ma J,et al.Risk factors for new vertebral compression fractures after percutaneous vertebroplasty:qualitative evidence synthesized from a systematic review[J].Spine(Phila Pa1976),2013,38(12):E713-722.
35 Hsu E,Nanes M.Advances in treatment of glucocorticoid-induced osteoporosis[J].Curr Opin Endocrinol Diabetes Obes,2017,24(6):411-417.
36 Rohlmann A,Pohl D,Bender A,et al.Activities of everyday life with high spinal loads[J].PLoS One,2014,9(5):e98510.
37 Cheng X,Long HQ,Xu JH,et al.Comparison of unilateral versus bilateral percutaneous kyphoplasty for the treatment of patients with osteoporosis vertebral compression fracture(OVCF):a systematic review and meta-analysis[J].Eur Spine J,2016,25(11):3439-3449.
38 Liebschner MA,Rosenberg WS,Keaveny TM.Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty[J].Spine(Phila Pa 1976),2001,26(14):1547-1554.
39 Jing Z,Dong J,Li Z,et al.Single balloon versus double balloon bipedicular kyphoplasty:a systematic review and meta-analysis[J].Eur Spine J,2018,27(10):2550-2564.
40杨航,彭成忠,曾庆虎,等.单双侧穿刺椎体成形术对邻近椎体再骨折影响的比较[J].生物骨科材料与临床研究,2018,15(5):41-44.
41 Liu J,Yu LJ,Song HP,et al.Analysis of correlative factors of non-surgical vertebral fractures after percutaneous vertebroplasty for osteoporotic vertebral compression fractures[J].Zhongguo Gu Shang,2013,26(3):190-193.
42 Knavel EM,Rad AE,Thielen KR,et al.Clinical outcomes with hemivertebral filling during percutaneous vertebroplasty[J].AJNRAm J Neuroradiol,2009,30(3):496-499.
43林森,陈小强,周涛,等.骨质疏松性椎体压缩性骨折椎体成形术后再骨折的影响因素分析[J].中华临床医师杂志(电子版),2016,10(12):1670-1673.
44 Ning L,Wan S,Liu C,et al.New Levels of Vertebral Compression Fractures after Percutaneous Kyphoplasty:Retrospective Analysis of Styles and Risk Factors[J].Pain Physician,2015,18(6):565-572.
45 Wang H,Zhang Z,Liu Y,et al.Percutaneous kyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures with spinal canal compromise[J].J Orthop Surg Res,2018,13(1):13.
46 Zhiyong C,Yun T,Hui F,et al.Unilateral Versus Bilateral Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures:A Systematic Review of Overlapping Meta-analyses[J].Pain Physician,2019,22(1):15-28.
47钟睿,王润生,刘建恒,等.经皮椎体强化术不同入路方式综述[J].解放军医学院学报,2019,40(2):196-198.
48周权发,刘宏建,寇红伟,等.弯角椎体成形装置的早期疗效评估及对骨水泥分布的影响[J].中国矫形外科杂志,2017,25(10):892-897.
49熊森,毛克亚,韩振川,等.弯角输送装置在体外椎体成形实验中的效果观察[J].解放军医学院学报,2016,37(7):769-772.
50钟睿,姜威,熊森,等.单侧弯角与直行入路椎体成形治疗骨质疏松性椎体压缩骨折疗效的对照研究[J].中华创伤杂志,2018,34(2):102-108.
51李世梁,连育才,孙海东,等.骨水泥分布系数及骨水泥量与经皮椎体后凸成形术早期疗效相关性分析[J/OL].http://kns.cnki.net/kcms/detail/50.1097.R.20190129.1332.017.html.
52李如义,牟林,安建鹏,等.微创椎弓根螺钉内固定联合椎体成形术治疗胸腰椎骨质疏松性骨折[J].世界最新医学信息文摘,2018,18(58):29-30.
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