■:通过基于三维体素的形态计量学(VBM)定量计算经皮椎体成形术(PVP)后骨折椎体的结构变化,比较单侧椎弓根椎体成形术(UEV)和双侧经椎弓根椎体成形术(BTV)。
■:我们计算了骨水泥体积(BCV);椎体体积(VBV);椎间盘内渗漏BCV;和空间,对称,甚至使用VBM用2种不同的PVP治疗的222个椎体中的骨水泥分布(BCD),并评估了随后的椎体压缩骨折(SVCF)的发生率。进行统计分析以比较2种不同的PVP之间的值。
■:相对BCV,这是SVCF的潜在风险因素,根据使用VBM的数据,BTV组较高(0.22±0.03vs.0.29±0.03;p<0.001,t检验);然而,两次手术之间的SVCF发生率没有显着差异(UEV,24.7%;BTV,31%;p=0.046,卡方检验)。Spatial,甚至,并且使用VBM在UEV和BTV之间沿3个轴的对称BCD没有显着差异(x,y,z轴,p=0.893,p=0.590,p=0.908,卡方检验)。
■:与直觉相反,UEV可以注入比BTV足够且更优化的BCV。此外,它可以在空间上注入骨水泥,对称,与基于VBM的BTV相比,分布均匀,没有增加椎间盘内渗漏率和SVCF。因此,UEV可能是一种优越的替代手术方法,具有相似的临床有效性和安全性,考虑到上述结果和UEV侵入性较小的共识。
OBJECTIVE: To compare unilateral extrapedicular vertebroplasty (UEV) and bilateral transpedicular vertebroplasty (BTV) by quantitatively calculating the structural changes of fractured vertebral body after percutaneous vertebroplasty (PVP) using 3-dimensional
voxel-based morphometry (VBM).
METHODS: We calculated bone cement volume (BCV); vertebral body volume (VBV); leaked intradiscal BCV; and spatial, symmetric, and even bone cement distribution (BCD) in and out of 222 vertebral bodies treated with 2 different PVPs using VBM and evaluated the incidence of subsequent vertebral compression fracture (SVCF). Statistical analyses were conducted to compare values between the 2 different PVPs.
RESULTS: Relative BCV, which is a potential risk factor for SVCF, was higher in the BTV group based on the data using VBM (0.22±0.03 vs. 0.29±0.03; p<0.001, t-test); however, the SVCF incidence between the 2 surgeries was not significantly different (UEV, 24.7%; BTV, 31%; p=0.046, chi-square test). Spatial, even, and symmetric BCD along the 3 axes was not significantly different between UEV and BTV using VBM (x, y, z-axis, p=0.893, p= 0.590, p=0.908 respectively, chi-square test).
CONCLUSIONS: Contrary to intuitive concerns, UEV can inject a sufficient and more optimal BCV than BTV. Additionally, it can inject bone cement spatially, symmetrically, and evenly well-distributed without an increased rate of intradiscal leakage and SVCF compared with BTV based on VBM. Therefore, UEV could be a superior alternative surgical method with similar clinical effectiveness and safety, considering the above results and the consensus that UEV is less invasive.