CAJ | 학술논문

目的探讨经皮椎体后凸成形术(PKP)后骨水泥分布与手术椎体再骨折的关系. 方法对2009年4月至2011年9月因骨质疏松椎体压缩骨折行PKP治疗的患者资料进行回顾性分析,共纳入86例患者,其中男17例,女69例；年龄47 ～87岁,平均68.1岁；随访时间3～16个月,平均3.4个月；69例患者行单侧穿刺,17例患者行双侧穿刺.评估性别、年龄、损伤节段、单或双侧穿刺、骨水泥是否同时接触上下终板、骨水泥是否偏一侧分布、术后初次下地时间、术后有无再次外伤等因素对手术椎体是否出现再骨折的影响. 结果 31例(36.0％)的患者在末次随访时发生了手术椎体再骨折.骨水泥未同时接触上下终板的患者发生手术椎体再骨折的几率较骨水泥同时接触上下终板的患者更高,差异有统计学意义(P＜0.05).骨水泥偏一侧分布未增加对侧再骨折的几率,差异无统计学意义(P＞0 05). 结论为避免手术椎体再骨折的发生,术中应尽量使骨水泥分布均匀同时接触上下终板.
목적 탐토경피추체후철성형술(PKP)후골수니분포여수술추체재골절적관계. 방법 대2009년4월지2011년9월인골질소송추체압축골절행PKP치료적환자자료진행회고성분석,공납입86례환자,기중남17례,녀69례；년령47 ～87세,평균68.1세；수방시간3～16개월,평균3.4개월；69례환자행단측천자,17례환자행쌍측천자.평고성별、년령、손상절단、단혹쌍측천자、골수니시부동시접촉상하종판、골수니시부편일측분포、술후초차하지시간、술후유무재차외상등인소대수술추체시부출현재골절적영향. 결과 31례(36.0％)적환자재말차수방시발생료수술추체재골절.골수니미동시접촉상하종판적환자발생수술추체재골절적궤솔교골수니동시접촉상하종판적환자경고,차이유통계학의의(P＜0.05).골수니편일측분포미증가대측재골절적궤솔,차이무통계학의의(P＞0 05). 결론 위피면수술추체재골절적발생,술중응진량사골수니분포균균동시접촉상하종판.
Objective To investigate the association between cement distribution pattern (lateral placement or endplate-to-endplate filling) and refracture of cemented vertebrae after percutaneous kyphoplasty (PKP). Methods A retrospective study was performed on the patients who had undergone PKP for osteoporotic vertebral compression fracture from April 2009 to September 2011.To eliminate the effect of confounding factors of multiple level surgery,this study only included 86 patients undergoing single level PKP.They were 17 males and 69 females,47 to 87 years of age (average,68.1 years).They obtained an average follow-up of 3.4 months (from 3 to 16 months).Unilateral cement injection was conducted in 69 patients and bilateral injection in 17 patients.Association between cement distribution pattern (lateral placement or endplate-to-endplate filling) and refracture of cemented vertebrae was analyzed.Associations of refracture of cemented vertebrae were analyzed with sex,age,vertebral level injured,cement placement (lateral or bilateral),endplate-to-endplate filling,unilateral distribution of cement,time to postoperative ambulation,and secondary postoperative injury. Results Refractures of cemented vertebrae occurred after PKP in 31 patients (36.0％).Failure to achieve endplate-to-endplate cement augmentation was found to be significantly associated with a refracture of cemented vertebra( P ＜ 0.05).Vertebral bodies in which cement was placed laterally did not appear to be at risk of collapse on the unaugmented side ( P ＞ 0.05). Conclusion To avoid refracture of the cemented vertebral body after PKP,endplate-to-endplate cement augmentation should be achieved.