【摘要】：目的:觀察經(jīng)皮椎體成形術(shù)(PVP)后手術(shù)椎體隨訪的核磁共振影像(MRI)特點(diǎn),分析其與臨床療效的相關(guān)性。方法:回顧性分析2015.1-2016.1在我院行椎體成形術(shù)的198例患者的臨床資料,其中資料完整且符合納入標(biāo)準(zhǔn)的患者為108例(152治療椎體),分析年齡,性別,椎體骨水泥的注入量,術(shù)前、術(shù)后1天X線影像(椎體高度),術(shù)前、術(shù)后3月、6月隨訪MRI影像結(jié)果(椎體高度、骨髓水腫)及術(shù)前、術(shù)后1天、術(shù)后3月、術(shù)后6月疼痛視覺(jué)模擬評(píng)分(VAS),并且著重收錄、分析、觀察患者術(shù)后的臨床表現(xiàn)。結(jié)果:術(shù)前和術(shù)后1天VAS分別為6.7±1.4分和2.1±0.7,差異有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后3月和術(shù)后6月VAS分別為1.7±0.8和1.2±0.6分。術(shù)后手術(shù)椎體高度較術(shù)前增加了2.4±1.8mm,術(shù)后六月隨訪中手術(shù)椎體高度丟失0.8±0.5mm,病人統(tǒng)計(jì)資料和椎體骨水泥注入量與PVP術(shù)后椎體高度丟失無(wú)關(guān)。其中28個(gè)(18%)椎體術(shù)后存在椎體高度丟失。62%的椎體術(shù)前MRI影像和33%椎體的隨訪MRI影像表現(xiàn)為椎體的中度或嚴(yán)重骨髓水腫。21%的椎體在隨訪時(shí)出現(xiàn)了新的骨髓水腫區(qū)域。22%的椎體在術(shù)后6個(gè)月的MRI影像中出現(xiàn)中度或重度的骨髓水腫。結(jié)論:PVP治療椎體骨質(zhì)疏松性壓縮骨折(OVCF)療效明顯,進(jìn)展性和持續(xù)性的骨髓水腫和椎體高度丟失是PVP術(shù)后常見(jiàn)的,不應(yīng)被視為手術(shù)椎體術(shù)后異常的足夠證據(jù)。
[Abstract]:Objective: to observe the magnetic resonance imaging (MRI) features of vertebra follow-up after percutaneous vertebroplasty (PVP) and to analyze its correlation with clinical efficacy. Methods: the clinical data of 198 patients underwent vertebroplasty in our hospital from January to June 2015.108 patients (152 treated vertebrae) with complete data were analyzed. The amount of bone cement injected into the vertebral body, X-ray imaging (vertebral height) before and 1 day after operation, MRI imaging results (vertebral height, bone marrow edema) before operation, 3 months after operation, and before operation, 1 day after operation, 3 months after operation. Visual analogue score (VAS),) of postoperative pain was collected and analyzed to observe the clinical manifestations of the patients. Results: VAS was 6.7 鹵1.4 and 2.1 鹵0.7 before operation and 1 day after operation, respectively (P0.05). VAS was 1.7 鹵0.8 and 1.2 鹵0.6 in 3 months and 6 months after operation, respectively. The postoperative vertebral body height increased by 2.4 鹵1.8 mm compared with that before operation, and the loss of postoperative vertebral body height was 0.8 鹵0.5 mm during 6 months follow-up. There was no correlation between the patient's statistical data and the amount of cement injected into the vertebral body after PVP. Among them, 28 (18%) had high loss of vertebral body after operation. 62% of the patients had preoperative MRI imaging and 33% of the follow-up MRI images showed moderate or severe bone marrow edema. 21% of the vertebrae showed moderate or severe bone marrow edema. New areas of bone marrow edema. 22% of vertebrae showed moderate or severe bone marrow edema on MRI imaging 6 months after operation. Conclusion: PVP is effective in the treatment of osteoporotic compression fracture of vertebral body (OVCF). Progressive and persistent bone marrow edema and loss of vertebral body height are common after PVP and should not be regarded as sufficient evidence of postoperative abnormality of vertebral body.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

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