The Value Of Imaging In Percutaneous Kyphoplasty For The Treatment Of Osteoporotic Vertebral Compressive Fracture

Introduction Preoperative imaging examination was taken on osteoporotic vertebralcompression fractures to understand compression degree and and operationindications;The ration and distribution of bone cement leakage in operation wereobserved by hibateral vertebral arch under X-ray.The postoperative follow-up of3to6months revealed to explore the restoration rate of the height and correct spinalkyphosis.Objective Explore the value of imaging in percutaneous kyphoplasty for thetreatment of osteoporotic vertebral compressive fractures；To explore the curativeeffect of percutaneous kyphoplasty for vertebral compression fracture；To discover thesensitivity of three kinds of imaging examination：CT、DR、MRI in diagnosis ofosteoporosis vertebral compressive fracture.Methods Forty-seven patients with osteoporotic compressive fractures, including22patients (24vertebral bodies) treated with PKP, rather have DR film (including x-rayfilm to Spine PA and LAT of preoperative, postoperative,and follow up from3to6months) and MRI (including preoperative, and follow up), from Nov2009-Mar2012.11Among the22patients also done the check of spiral CT three-dimensionalreconstruction. Vertebral morphology、Lateral bending degree、were observed indifferent imaging.The anterior vertebrae height,center vertebral height,and vertebraecobb angle were measured in lumber spine preoperative,on postoperative and followup from3to6months. The ration and distribution of bone cement leakage in operation were observed by hibateral vertebral arch under X-ray.Explore the height ofimprovement of damaged vertebral bodies,the height loss of damaged vertebral bodysduring follow up, the change of vertebrae cobb angle. The fracture of adjacentvertebrae at the last follow up were diagnosed by MRI and X-ray of follow up.Results A total24vertebrals of22patients were diagnosised of new compressionfractures by MRI,19of them were wedging, the others were biconcave deformities,besides,3of the24vertebrals becomes flat.7vertebrals were diagnosised of oldcompression fractures by MRI,3of them were wedging,2were biconcavedeformities, and the others becomes flat. DR shows15were wedging,8werebiconcave deformities, and3becomes flat，12vertebrae were found fracture line inmorphological abnormalities. In11patients,9cases can see the fracture line，vertebralcortical bone were integrity. In22patients,3patients with kyphosis.,24Preoperativeanterior,the center vertebrae heights were （1.92±0.19cm）,（2.18±0.36cm）, thevertebrae cobb angle were （22.62±4.36°）, the postoperative anterior,the centervertebrae heights were （2.38±0.28cm）,（2.52±0.39cm）, the vertebrae cobb anglewere （12.36±1.57°）, the follow up from3to6months anterior,the center vertebraeheights were （2.3750±0.2782cm）,（2.5121±0.3894cm）, the recovery ofanterior vertebrae height,center vertebrae height,vertebrae cobb angle betweenperoperation and post operation was significantly different. At the last follow up,theloss of damaged anterior vertebrae height,and the center vertebrae heights were notdifferent compared to that of postoperation. The ration of bone cement leakage inoperation is12.5%, to observe the bone cement of diffusion of PKP got or notacross the midline, and at the last follow-up,2patients occurred new fracturesoccurred in adjacent vertebrae,the probability of the adjacent vertebral fracture isabout8.33%。CT3D reconstruction of vertebral fracture shows the posterior vertebraeout of fracture.Conclusion Imaging has certain value in percutaneous kyphoplasty for the treatment of new benign osteoporotic vertebral compressive fracture.Compared with CT,DR,MRI is more sensitive to vertebral fracture.PKP has significantly effect inreplacement of osteoporotic vertebral compressive fracture patients．However，Therestill has some controversial：the incidence of adjacent vertebra fracture.