文献类型：期刊文献

中文题名：经皮椎体成形术与非手术治疗MRI STIR序列同源高信号骨质疏松性椎体压缩骨折的比较

英文题名：Comparison of percutaneous vertebroplasty and non-surgical treatment for osteoporotic vertebral compression fractures with homogeneous high signal intensity on MRI STIR sequence

作者：胡文均[1];郑杰文[1];王超[1];吴中杰[1];夏晨波[1];简思莹[1];沈海良[1]

机构：[1]绍兴文理学院附属医院骨科,浙江绍兴312000

年份：2025

卷号：40

期号：3

起止页码：248

中文期刊名：中国骨与关节损伤杂志

外文期刊名：Chinese Journal of Bone and Joint Injury

基金：浙江省卫生健康科技计划项目(2021KY1160);绍兴市卫生健康科技计划项目(2023SKY088);绍兴文理学院校级科研项目(2024LG013)。

语种：中文

中文关键词：骨质疏松性椎体压缩骨折;核磁共振成像;脂肪抑制序列;同源高信号;经皮椎体成形术;非手术治疗

外文关键词：Osteoporotic vertebral compression fracture;Magnetic resonance imaging;Fat suppression;Homogenous hyperin tensity signal;Percutaneous vertebroplasty;Non-surgical treatment

中文摘要：目的比较经皮椎体成形术与非手术治疗MRI STIR序列同源高信号骨质疏松性胸腰椎椎压缩骨折的临床疗效,探讨MRI同源高信号在此类骨折治疗方法选择中的意义。方法回顾性分析自2016-01—2018-12诊治的57例MRI STIR序列同源高信号骨质疏松性椎体压缩骨折,30例采用经皮椎体成形术治疗(椎体成形组),27例采用非手术治疗(非手术组)。比较两组术后疼痛VAS评分、ODI指数、SF-36量表评分、伤椎椎体前缘高度比值、伤椎Cobb角。结果57例均获得随访,随访时间为治疗后3 d、3个月及12个月。椎体成形组1例出现骨水泥渗漏,渗漏区域为上位椎间盘。所有患者均无神经损伤和邻近节段椎体骨折。椎体成形组术后1年均达到骨折愈合标准,非手术组1例未达到骨折愈合标准。椎体成形组治疗后第3天、治疗后1年伤椎椎体前缘高度比值、伤椎Cobb角优于非手术组,差异有统计学意义(P<0.05)。椎体成形组与非手术组治疗后3个月、治疗后1年疼痛VAS评分、ODI指数、SF-36量表评分差异无统计学意义(P>0.05)。结论经皮椎体成形术和非手术治疗MRI STIR序列同源高信号骨质疏松性胸腰椎压缩骨折的远期疗效相当,MRI STIR序列特征性同源高信号在此类骨折治疗方案选择上具有一定价值。

外文摘要：Objective To compare the clinical efficacy of percutaneous vertebroplasty and non-surgical treatment for osteoporotic vertebral compression fractures with homogeneous high signal intensity on MRI STIR sequences and to explore the significance of MRI homogeneous high signal intensity in guiding treatment selection for such fractures.Methods A retrospective analysis was conducted on 57 patients with osteoporotic vertebral compression fractures with homogeneous high signal intensity on MRI STIR sequences diagnosed and treated between January 2016 and December 2018.Among them,30 patients underwent percutaneous vertebroplasty(PVP group),while 27 received non-surgical treatment(non-surgical group).The postoperative pain assessed by the visual analog scale(VAS),Oswestry disability index(ODI),Short Form-36(SF-36)scores,anterior vertebral height ratio of the fractured vertebra,and Cobb angle of the injured vertebra,were compared between the two groups.Results All 57 patients were followed up on the 3~(rd)day,and at 3 months and 12 months after treatment.One case in the PVP group experienced bone cement leakage into the superior intervertebral disc,but no patients developed neurological deficits or adjacent vertebral fractures.At the 12-month follow-up,all fractures in the PVP group had achieved radiographic healing,whereas one case in the non-surgical group did not meet the healing criteria.The PVP group showed significantly better anterior vertebral height ratio and Cobb angle of the injured vertebra on the 3~(rd)day and at 12 month after treatment compared to the nonsurgical group(P<0.05).However,there were no statistically significant differences between the two groups in terms of VAS pain scores,ODI index,and SF-36 scores at 3 months and 12 months after treatment(P>0.05).Conclusion Percutaneous vertebroplasty and non-surgical treatment provide comparable long-term outcomes for osteoporotic compression fractures with homogeneous high signal intensity on MRI STIR sequences.The characteristic homogeneous high signal on MRI STIR sequences may have clinical value in guiding the selection of treatment strategies for these fractures.