CAJ | 학술논문

目的：比较椎体后凸成形术（BKP）治疗骨质疏松性椎体骨折（OVCFs）伴或不伴裂隙征（IVC）的疗效。方法回顾性分析50例行BKP治疗的OVCFs患者，按术前是否存在IVC分成两组，测量其术前、术后及末次随访时X线片伤椎前缘高度、伤椎中部高度及伤椎局部后凸角，观测骨水泥在伤椎内的分布形态及渗漏情况；采用VAS及ODI评分评估手术疗效。结果 IVC组与非IVC组术后及末次随访伤椎前缘高度、伤椎中部高度及伤椎局部后凸角均优于术前，IVC组伤椎前缘高度纠正、伤椎中部高度纠正及伤椎局部后凸角纠正均优于非IVC组。两组术后及末次随访VAS及ODI评分均较术前明显改善，而术后与末次随访相比，差异无统计学意义。骨水泥分布形态IVC组团块型占65.0％，非IVC组团块型占13.3％。IVC组椎间盘内渗漏3例，椎前渗漏1例；非IVC组椎前渗漏1例。结论 BKP对伴或不伴IVC的骨质疏松性椎体骨折均安全有效；伤椎椎体高度恢复及局部后凸角纠正，IVC组优于非IVC组；IVC组骨水泥分布以团块型为主，骨水泥渗漏以椎间盘内为主。
목적：비교추체후철성형술（BKP）치료골질소송성추체골절（OVCFs）반혹불반렬극정（IVC）적료효。방법회고성분석50례행BKP치료적OVCFs환자，안술전시부존재IVC분성량조，측량기술전、술후급말차수방시X선편상추전연고도、상추중부고도급상추국부후철각，관측골수니재상추내적분포형태급삼루정황；채용VAS급ODI평분평고수술료효。결과 IVC조여비IVC조술후급말차수방상추전연고도、상추중부고도급상추국부후철각균우우술전，IVC조상추전연고도규정、상추중부고도규정급상추국부후철각규정균우우비IVC조。량조술후급말차수방VAS급ODI평분균교술전명현개선，이술후여말차수방상비，차이무통계학의의。골수니분포형태IVC조단괴형점65.0％，비IVC조단괴형점13.3％。IVC조추간반내삼루3례，추전삼루1례；비IVC조추전삼루1례。결론 BKP대반혹불반IVC적골질소송성추체골절균안전유효；상추추체고도회복급국부후철각규정，IVC조우우비IVC조；IVC조골수니분포이단괴형위주，골수니삼루이추간반내위주。
Objective To compare the outcomes of osteoporotic vertebral compression fractures with or without IVC treated by BKP. Method Fifty patients with OVCFs underwent BKP between January 2009 and June 2013. We divided the fifty patients into two groups according to the existence of IVC. The kyphotic angle,anterior and middle vertebral height were measured on lateral radiographs at preoperatively,postoperatively and final follow-up. Cement distrubution patterns and leakage were also accessed on postoperative radiographs or CT scans.Visual analog scale(VAS)and Oswestry disability index(ODI)scores were used to evaluate pain and function results. Results The two groups both had significant correction of kyphotic angle as well as anterior and middle vertebral height restoration.But the restoration of kyphotic angle and vertebral height in group with IVC were better than group without IVC.In addition,both groups had significant improvement of VAS and ODI scores.Lump cement pattern accounted for 65.0% of all cemented vertebrae in group with IVC and 13.3%in group without IVC. Three vertebrae had intradiscal cement leakage and one vertebra had peri-vertebral leakage in group with IVC,while just one vertebra which had peri-vertebral leakage was detected in group without IVC. Conclusions BKP is safe and effective for the treatment of OVCFs with and without IVC,however,the restoration of kyphotic angle and vertebral height was significant in vertebrae with IVC,More lump cement and intradiscal leakage were detected in vertebra with IVC.