Conversion to hypertrophic vertebral pseudarthrosis following percutaneous vertebroplasty

经皮椎体成形术后转化为肥厚性椎体假关节

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Abstract

To determine the role of percutaneous vertebroplasty (PVP) in bone formation and the union of vertebral pseudarthrosis, we analyzed 14 patients with an average follow-up duration of 21 months. Evaluation methods included back pain (visual analog scale: VAS), wedge angle, dynamic mobility, radiographic remodeling including callus and spur formation, and union status. The Student's t test was used for statistical analysis and a probability of less than 0.05 was determined as a significant difference. Back pain improved in all 14 patients with a VAS score of 57.8 +/- 23.5 mm (average +/- standard deviation) preoperatively and 14.7 +/- 16.4 mm at the final follow-up (P < 0.001). The wedge angle decreased from 21.6 degrees +/- 8.3 degrees (average +/- standard deviation) preoperatively to 13.2 degrees +/- 6.9 degrees at the final follow-up (P < 0.001). Callus formation was seen in four patients. Bony spurs were seen in the affected vertebra in preoperative radiographs in all patients, and were further developed to a solidified form during follow up after PVP. Dynamic mobility of the affected vertebrae was 6.9 +/- 2.9 mm preoperatively, which decreased to 1.1 degrees +/- 0.7 degrees at the final follow-up (P < 0.001). Notably, all patients showed the dynamic vertebral mobility of 2 mm or less. Nevertheless, only two patients exhibited the dynamic vertebral mobility of 0 mm at the final follow-up, which is referred to as bone union. These findings indicate that PVP serves as a mechanical stabilizer for vertebral pseudarthrosis, which leads to immediate pain relief and segmental bony responses.

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