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[目的]分析骨质疏松椎体压缩骨折(osteoporotic vertebral compression fractures,OVCFs)中椎体内裂隙(intravertebral vacuum cleft,IVC)发病率及其在伤椎内位置特点,并比较不同位置IVC对经皮椎体强化术治疗有IVC的OVCFs治疗效果影响差异。[方法]共有52例单节段并位于胸腰区域(T_(11)~L_1)有IVC的OVCFs患者纳入回顾性研究,随访时间均超过两年。根据IVC在伤椎内的位置特点,将所有患者分为三组:IVC偏上组、IVC偏下组和IVC达到上下终板组。三组组间及组内相应的放射学和临床参数在术前、术后(即时、术后1年、术后2年)分别比较。[结果]三组患者术前基值差异均无统计学意义,具有可比性。三组患者术后即时的椎体高度及后凸角均显著矫正;三组术后即时放射学及临床参数差异无统计学意义。在术后1、2年随访期间内,三组患者椎体高度及后凸角角均进展性加重,尤以IVC偏下组为最重,其次是IVC偏上组。三组在伤椎复位率及复位角差异无统计学意义(P<0.05);IVC偏下组2年内的高度及后凸丢失率显著超过其他两组(P<0.05)。[结论]经皮椎体强化术起初对于所有IVC的OVCFs患者有效。然而,在后期随访中IVC偏下组更易出现严重的椎体再塌陷及后凸畸形,因此建议术后需要严密的观察及随访。
[Objective] To analyze the incidence of intravertebral vacuum cleft (IVC) and its location in injured vertebrae in osteoporotic vertebral compression fractures (OVCFs) and to compare the effect of IVC in different position on percutaneous The effect of vertebroplasty in the treatment of OVC with IVC is different. [Methods] A total of 52 OVCFs with single segment and located in the thoracolumbar region (T_ (11) ~ L_1) with IVC were enrolled in the retrospective study. All the patients were followed up for more than two years. All the patients were divided into three groups according to the IVC’s position in the injured vertebra. IVC upper group, IVC lower group and IVC reached the upper and lower endplate group. The corresponding radiological and clinical parameters in the three groups and in the group were compared before and after surgery (immediately, 1 year after surgery and 2 years after surgery). [Results] There was no significant difference between the three groups in preoperative baseline values, which was comparable. Three groups of patients postoperative immediate vertebral height and kyphotic angle were significantly corrected; three groups of postoperative real-time radiological and clinical parameters showed no significant difference. In the 1-year and 2-year follow-up period, the vertebral body height and kyphotic angle of the three groups were both progressive, especially in the IVC subgroup, followed by IVC in the upper group. There was no significant difference between the three groups in the reduction rate of the injured vertebra and the reset angle (P <0.05). The height and kyphosis loss in the IVC inferior group was significantly more than the other two groups in two years (P <0.05). [Conclusion] Percutaneous vertebroplasty was initially effective for all IVC patients with OVCFs. However, in the follow-up IVC partial group more prone to severe vertebral body collapse and kyphosis, so the proposed postoperative need for close observation and follow-up.