椎体后凸成形治疗Kummell病过程中发生的骨水泥渗漏
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摘要
背景:目前关于骨质疏松性椎体骨折形态及磁共振表现与Kummell病的相关性已有相关报道,但关于骨质疏松性椎体骨折程度与Kummell病相关性的报道较少。目的:分析骨质疏松性椎体骨折Genant分级与Kummell病的相关性,探讨Kummell病椎体后凸成形治疗中骨水泥并发症的防治。方法:选择行保守治疗的老年骨质疏松性椎体压缩骨折患者84例,共109例椎体,涉及骨折椎体节段为T_(9-L4),依据Genant半定量评估法将骨折椎体进行分级(轻度畸形48例、中度畸形34例、重度畸形27例),保守治疗6个月后复诊,MRI成像观察骨折椎体节段裂隙征发生情况,判定Kummell病,同时评估严重程度(Ⅰ型、Ⅱ型、Ⅲ型)。对诊断为Kummell病的患者进行骨水泥椎体后凸成形治疗,X射线观察骨水泥渗漏情况,治疗后随访观察疼痛、腰背部功能、椎体前缘高度及伤椎Cobb角恢复情况。结果与结论:(1)84例患者中,23例出现骨折椎体节段裂隙征,轻、中、重度畸形患者中骨折椎体节段裂隙征的发生率分别为3%,6%,12%,以T_(12)椎体多发;(2)23例Kummell病患者经骨水泥椎体后凸成形治疗后,6例Ⅰ型患者中发生骨水泥椎间盘渗漏、椎旁渗漏各1例,14例Ⅱ型患者中发生2例骨水泥椎间盘渗漏、1例椎旁渗漏,3例Ⅲ型患者中发生骨水泥椎间盘渗漏、椎旁渗漏各1例;不同分型间椎间盘渗漏、椎旁渗漏发生率比较无差异;(3)23例患者治疗后随访6个月时的疼痛、腰背部功能、椎体前缘高度及伤椎Cobb角均较治疗前明显改善(P <0.05);(4)结果表明,随着骨质疏松性椎体骨折Genant分级的提高,Kummell病发生率随之增加,采用椎体后凸成形治疗Kummell病后的骨水泥渗漏率较高,且多趋于椎间盘内渗漏。
BACKGROUND: Kummell disease has certain correlation with osteoporotic vertebral fracture morphology andmagnetic resonance imaging manifestations; however, few reports focus on the correlation between the severity of osteoporotic vertebral fracture and Kummell disease. OBJECTIVE: To analyze the correlation between Genant classification and Kummell disease in osteoporotic vertebral fractures, and to investigate the prevention and treatment of bone cement complications during percutaneous kyphoplasty for the treatment of Kummell disease. METHODS: Eighty-four elderly patients with osteoporotic vertebral compression fractures undergoing conservative treatment were selected. A total of 109 cases of vertebral bodies were involved. The T9-L4 vertebral body segments were involved in fractures. Fracture vertebral bodies were graded according to the Genant semi-quantitative assessment method(48 cases of mild malformation, 34 cases of moderate malformation, and 27 cases of severe malformation). After 6 months of conservative treatment, they were referred again. MRI imaging was performed to observe the occurrence of fractured vertebral body segmental cleft, to determine Kummell disease, and to assess the severity of disease(type I, II, III). For patients diagnosed with Kummell disease, kyphoplasty with bone cement was performed. The bone cement leakage was observed by X-ray. The pain, lumbar back function, height of anterior vertebral body and recovery of Cobb angle were observed after treatment. RESULTS AND CONCLUSION:(1) Of the 184 patients, intervertebral vacuum cleft sign was found in 23 cases(mostly in the T12 segment), and its incidence with mild, moderate, and severe malformations was 3%, 6%, and 12%, respectively.(2) After kyphoplasty with bone cement, 1 case of intervertebral disc leakage and 1 case of paravertebral leakage were found in the 6 cases of type I Kummell disease; 2 cases of cemented intervertebral disc leakage and 1 case of paravertebral leakage were found in the 14 cases of type II Kummell disease; and 1 case of cemented intervertebral disc leakage and 1 case of paravertebral leakage were found in the 3 cases of type III Kummell disease. There was no difference in the incidence of intervertebral disc leakage and paravertebral leakage between different subtypes.(3) The pain, lumbar back function, anterior vertebral height and Cobb angle were significantly improved in 23 patients with Kummell disease at the 6-month follow-up(P < 0.05). These results reveal that with the increasing of Genant grading, the incidence of Kummell disease increases. The rate of bone cement leakage after kyphoplasty for Kummell disease is at a high level, and intradiscal leakage tends to occur in most cases.
BACKGROUND: Kummell disease has certain correlation with osteoporotic vertebral fracture morphology andmagnetic resonance imaging manifestations; however, few reports focus on the correlation between the severity of osteoporotic vertebral fracture and Kummell disease. OBJECTIVE: To analyze the correlation between Genant classification and Kummell disease in osteoporotic vertebral fractures, and to investigate the prevention and treatment of bone cement complications during percutaneous kyphoplasty for the treatment of Kummell disease. METHODS: Eighty-four elderly patients with osteoporotic vertebral compression fractures undergoing conservative treatment were selected. A total of 109 cases of vertebral bodies were involved. The T9-L4 vertebral body segments were involved in fractures. Fracture vertebral bodies were graded according to the Genant semi-quantitative assessment method(48 cases of mild malformation, 34 cases of moderate malformation, and 27 cases of severe malformation). After 6 months of conservative treatment, they were referred again. MRI imaging was performed to observe the occurrence of fractured vertebral body segmental cleft, to determine Kummell disease, and to assess the severity of disease(type I, II, III). For patients diagnosed with Kummell disease, kyphoplasty with bone cement was performed. The bone cement leakage was observed by X-ray. The pain, lumbar back function, height of anterior vertebral body and recovery of Cobb angle were observed after treatment. RESULTS AND CONCLUSION:(1) Of the 184 patients, intervertebral vacuum cleft sign was found in 23 cases(mostly in the T12 segment), and its incidence with mild, moderate, and severe malformations was 3%, 6%, and 12%, respectively.(2) After kyphoplasty with bone cement, 1 case of intervertebral disc leakage and 1 case of paravertebral leakage were found in the 6 cases of type I Kummell disease; 2 cases of cemented intervertebral disc leakage and 1 case of paravertebral leakage were found in the 14 cases of type II Kummell disease; and 1 case of cemented intervertebral disc leakage and 1 case of paravertebral leakage were found in the 3 cases of type III Kummell disease. There was no difference in the incidence of intervertebral disc leakage and paravertebral leakage between different subtypes.(3) The pain, lumbar back function, anterior vertebral height and Cobb angle were significantly improved in 23 patients with Kummell disease at the 6-month follow-up(P < 0.05). These results reveal that with the increasing of Genant grading, the incidence of Kummell disease increases. The rate of bone cement leakage after kyphoplasty for Kummell disease is at a high level, and intradiscal leakage tends to occur in most cases.
引文
[1]Ranjan M,Mahadevan A,Prasad C,et al.Kummell's diseaseuncommon or underreported disease:A clinicopathological account of a case and review of literature.J Neurosci Rural Pract.2013;4(4):439-442.
[2]Nickell LT,Schucany WG,Opatowsky MJ.Kummell disease.Proc(Bayl Univ Med Cent).2013;26(3):300-301.
[3]Lim J,Choi SW,Youm JY,et al.Posttraumatic Delayed Vertebral Collapse:Kummell's Disease.J Korean Neurosurg Soc.2018;61(1):1-9.
[4]Kim H,Jun S,Park SK,et al.Intravertebral vacuum cleft sign:a cause of vertebral cold defect on bone scan.Skeletal Radiol.2016;45(5):707-712.
[5]Zha LL,Tong PJ,Xia LW,et al.Diagnostic analysis of the radiologic characteristics in osteoporotic Kiinmmel's disease.Zhongguo Gu Shang.2016;29(5):460-463.
[6]Yu W,Jiang X,Liang,et al.Intravertebral Vacuum Cleft and Its Varied Locations within Osteoporotic Vertebral Compression Fractures:Effect on Therapeutic Efficacy.Pain Physician.2017;20(6):E979-E986.
[7]Yang H,Liu H,Wang S,et al.Review of Percutaneous Kyphoplasty in China.Spine(Phila Pa 1976).2016;41 Suppl 19:B52-B58.
[8]Matzaroglou C,Georgiou CS,Panagopoulos A,et al.Kummell's Disease Clarifying the Mechanisms and Patients'Inclusion Criteria.Open Orthop J.2014;8:288-297.
[9]Libicher M,Appelt A,Berger I,et al.The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures:results from a radiological and histological study.Eur Radiol.2007;17(9):2248-2252.
[10]李良辰,何登伟,黄文君,等.Kummell病椎体裂隙征发生机制的研究进展[J]中华骨质疏松和骨矿盐疾病杂志,2015,8(4):363-366.
[11]钟远鸣,李兵,李智斐,等.骨质疏松性椎体骨折椎体形态与Kummell病的相关性[J].实用医学杂志,2015,31(22):3661-3662.
[12]Tsujio T,Nakamura H,Terai H,et al.Characteristic radiographic or magnetic resonance images of fresh osteoporotic vertebral fractures predicting potential risk for nonunion:a prospective multicenter study.Spine(Phila Pa 1976).2011;36(15):1229-1235.
[13]Muratore M,Ferrera A,Masse A,et al.Osteoporotic vertebral fractures:predictive factors for conservative treatment failure.A systematic review.Eur Spine J.2017.doi:10.1007/s00586-017-5340-z.[Epub ahead of print]
[14]Kanchiku T,Imajo Y,Suzuki H,et al.Usefulness of an early MRI-based classification system for predicting vertebral collapse and pseudoarthrosis after osteoporotic vertebral fractures.J Spinal Disord Tech.2014;27(2):E61-65.
[15]Tome-Bermejo F,Pinera AR,Duran-Alvarez C,et al.Identification of Risk Factors for the Occurrence of Cement Leakage During Percutaneous Vertebroplasty for Painful Osteoporotic or Malignant Vertebral Fracture.Spine(Phila Pa 1976).2014;39(11):E693-E700.
[16]Formica M,Basso M,Cavagnaro L,et al.Kummell disease:illustrative case for definition criteria.Spine J.2016;16(10):e707-e708.
[17]Genant HK.Assessment of vertebral fractures in osteoporosis research.J Rheumatol.1997;24(6):1212-1214.
[18]Li KC,Wong TU,Kung FC.Staging of Kümmell's disease.J Musculoskel Res.2004;8(1):43-55.
[19]Kummell H.Die rarefizierende ostitis der wirbelkorper.Deutsche Med.1895;21:180-181.
[20]Ma R,Chow R,Shen FH.Kummell's disease:delayed post-traumatic osteonecrosis of the vertebral body.Eur Spine J.2010;19(7):1065-1070.
[21]Young WF,Brown D,Kendler A,et al.Delayed post-traumatic osteonecrosis of a vertebral body(Kummell's disease).Acta Orthop Belg.2002;68(1):13-19.
[22]张磊磊,李健.Kummell病的研究进展[J].中国矫形外科杂志,2015,23(9):816-819.
[23]van der Schaaf I,Fransen H.Percutaneous vertebroplasty as treatment for Kummell's disease.JBR-BTR.2009;92(2):83-85.
[24]Marie PJ,Kassem M.Osteoblasts in osteoporosis:past,emerging,and future anabolic targets.Eur J Endocrinol.2011;165(1):1-10.
[25]Matzaroglou C,Georgiou CS,Assimakopoulos K,et al.Kummell's disease:pathophysiology,diagnosis,treatment and the role of nuclear medicine.Rationale according to our experience.Hell J Nucl Med.2011;14(3):291-299.
[26]Wu AM,Chi YL,Ni WF.Vertebral compression fracture with intravertebral vacuum cleft sign:pathogenesis,image,and surgical intervention.Asian Spine J.2013;7(2):148-155.
[27]He D,Yu W,Chen Z,et al.Pathogenesis of the intravertebral vacuum of Kummell's disease.Exp Ther Med.2016;12(2):879-882.
[28]Laredo JD.Expert's comment concerning Grand Rounds case entitled"Kümmell's disease:delayed post-traumatic osteonecrosis of the vertebral body"(by R.Ma,R.Chow,F.H.Shen).Eur Spine J.2010;19(7):1071-1072.
[29]Matzaroglou C,Georgiou CS,Assimakopoulos K,et al.Kummell's disease:A rare spine entity in a young adult.Hell J Nucl Med.2010;13(1):52-55.
[30]Baba H,Maezawa Y,Kamitani K,et al.Osteoporotic vertebral collapse with late neurological complications.Paraplegia.1995;33(5):281-289.
[31]Wang Q,Wang C,Fan S,et al.Pathomechanism of intravertebral clefts in osteoporotic compression fractures of the spine:basivertebral foramen collapse might cause intravertebral avascular necrosis.Spine J.2014;14(6):1090-1091.
[32]Wang H,Sribastav SS,Ye F,et al.Comparison of Percutaneous Vertebroplasty and Balloon Kyphoplasty for the Treatment of Single Level Vertebral Compression Fractures:A Meta-analysis of the Literature.Pain Physician.2015;18(3):209-222.
[33]Zhang H,Xu C,Zhang T,et al.Does Percutaneous Vertebroplasty or Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures Increase the Incidence of New Vertebral Fractures?AMeta-Analysis.Pain Physician.2017;20(1):E13-E28.
[34]杨惠林.科学认识椎体成形术与椎体后凸成形术的临床价值[J].中国脊柱脊髓杂志,2010,20(6):441-443.
[35]Mc Connell CT Jr,Wippold FJ 2nd,Ray CE Jr,et al.ACRappropriateness criteria management of vertebral compress fratures.JAm Coll Radiol.2014;11(8):757-763.
[36]Kim YC,Kim YH,Ha KY.Pathomechanism of intravertebral clefts in osteoporotic compression fractures of the spine.Spine J.2014;14(4):659-666.
[37]Ren H,Wang J,Chen J,et al.Clinical efficacy of unipedicular versus bipedicular percutaneous vertebroplasty for Kummell's disease.JSouth Med Univ.2014;34(9):1370-1374.
[38]Venmans A,Klazen CA,van Rooij WJ,et al.Postprocedural CT for perivertebral cement leakage in percutaneous vertebroplasty is not necessary--results from VERTOS II.Neuroradiology.2011;53(1):19-22.
[39]Saracen A,Kotwica Z.Complications of percutaneous vertebroplasty:An analysis of 1100 procedures performed in 616 patients.Medicine.2016;95(24):e3850.
[40]Yang H,Gan M,Zou J,et al.Kyphoplasty for the treatment of Kümmell's disease.Orthopedics.2010;33(7):479.
[41]Ha KY,Lee JS,Kim KW,et al.Percutaneous vertebroplasty for vertebral compression fractures with and without intravertebral clefts.J Bone Joint Surg Br.2006;88:629-633.
[42]Kong LD,Wang P,Wang LF,et al.Comparison of vertebroplasty and kyphoplasty in the treatment of osteoporoticvertebral compression fractures with intravertebral clefts.Eur J Orthop Surg Traumatol.2014;24(Suppl 1):S201-208.
[43]Tanigawa N,Kariya S,Komemushi A,et al.Cement leakage in percutaneous vertebroplasty for osteoporotic compression fractures with or without intravertebral clefts.AJR Am J Roentgenol.2009;193:W442-445.
[44]Komemushi A,Tanigawa N,Kariya S,et al.Percutaneous vertebroplasty for osteoporotic compression fracture:multivariate study of predictors of new vertebral body fracture.Cardiovasc Intervent Radiol.2006;29:580-585.
[45]Kim YJ,Lee JW,Park KW,et al.Pulmonary cement embolism after percutaneous vertebroplasty in osteoporotic vertebral compression fractures:incidence,characteristics,and risk factors.Radiology.2009;251:250-259.
[46]Ren H,Shen Y,Zhang YZ,et al.Correlative factor analysis on the complications resulting from cement leakage after percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture.J Spinal Disord Tech.2010;23:e9-15.
[47]Chen L,Dong R,Gu Y,et al.Comparison between Balloon Kyphoplasty and Short Segmental Fixation Combined with Vertebroplasty in the Treatment of Kümmell's Disease.Pain Physician.2015;18(4):373-381.
[48]Zhang ZF,Yang JL,Jiang HC,et al.An updated comparison of high-and low-viscosity cement vertebroplasty in the treatment of osteoporotic thoracolumbar vertebral compression fractures:A retrospective cohort study.Int J Surg.2017;43:126-130.
[49]Wu AM,Li XL,Li XB,et al.The outcomes of percutaneous kyphoplasty in treatment of the secondary osteoporotic vertebral compression factures:a case-control study.Ann Transl Med.2018;6(6):107.
[2]Nickell LT,Schucany WG,Opatowsky MJ.Kummell disease.Proc(Bayl Univ Med Cent).2013;26(3):300-301.
[3]Lim J,Choi SW,Youm JY,et al.Posttraumatic Delayed Vertebral Collapse:Kummell's Disease.J Korean Neurosurg Soc.2018;61(1):1-9.
[4]Kim H,Jun S,Park SK,et al.Intravertebral vacuum cleft sign:a cause of vertebral cold defect on bone scan.Skeletal Radiol.2016;45(5):707-712.
[5]Zha LL,Tong PJ,Xia LW,et al.Diagnostic analysis of the radiologic characteristics in osteoporotic Kiinmmel's disease.Zhongguo Gu Shang.2016;29(5):460-463.
[6]Yu W,Jiang X,Liang,et al.Intravertebral Vacuum Cleft and Its Varied Locations within Osteoporotic Vertebral Compression Fractures:Effect on Therapeutic Efficacy.Pain Physician.2017;20(6):E979-E986.
[7]Yang H,Liu H,Wang S,et al.Review of Percutaneous Kyphoplasty in China.Spine(Phila Pa 1976).2016;41 Suppl 19:B52-B58.
[8]Matzaroglou C,Georgiou CS,Panagopoulos A,et al.Kummell's Disease Clarifying the Mechanisms and Patients'Inclusion Criteria.Open Orthop J.2014;8:288-297.
[9]Libicher M,Appelt A,Berger I,et al.The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures:results from a radiological and histological study.Eur Radiol.2007;17(9):2248-2252.
[10]李良辰,何登伟,黄文君,等.Kummell病椎体裂隙征发生机制的研究进展[J]中华骨质疏松和骨矿盐疾病杂志,2015,8(4):363-366.
[11]钟远鸣,李兵,李智斐,等.骨质疏松性椎体骨折椎体形态与Kummell病的相关性[J].实用医学杂志,2015,31(22):3661-3662.
[12]Tsujio T,Nakamura H,Terai H,et al.Characteristic radiographic or magnetic resonance images of fresh osteoporotic vertebral fractures predicting potential risk for nonunion:a prospective multicenter study.Spine(Phila Pa 1976).2011;36(15):1229-1235.
[13]Muratore M,Ferrera A,Masse A,et al.Osteoporotic vertebral fractures:predictive factors for conservative treatment failure.A systematic review.Eur Spine J.2017.doi:10.1007/s00586-017-5340-z.[Epub ahead of print]
[14]Kanchiku T,Imajo Y,Suzuki H,et al.Usefulness of an early MRI-based classification system for predicting vertebral collapse and pseudoarthrosis after osteoporotic vertebral fractures.J Spinal Disord Tech.2014;27(2):E61-65.
[15]Tome-Bermejo F,Pinera AR,Duran-Alvarez C,et al.Identification of Risk Factors for the Occurrence of Cement Leakage During Percutaneous Vertebroplasty for Painful Osteoporotic or Malignant Vertebral Fracture.Spine(Phila Pa 1976).2014;39(11):E693-E700.
[16]Formica M,Basso M,Cavagnaro L,et al.Kummell disease:illustrative case for definition criteria.Spine J.2016;16(10):e707-e708.
[17]Genant HK.Assessment of vertebral fractures in osteoporosis research.J Rheumatol.1997;24(6):1212-1214.
[18]Li KC,Wong TU,Kung FC.Staging of Kümmell's disease.J Musculoskel Res.2004;8(1):43-55.
[19]Kummell H.Die rarefizierende ostitis der wirbelkorper.Deutsche Med.1895;21:180-181.
[20]Ma R,Chow R,Shen FH.Kummell's disease:delayed post-traumatic osteonecrosis of the vertebral body.Eur Spine J.2010;19(7):1065-1070.
[21]Young WF,Brown D,Kendler A,et al.Delayed post-traumatic osteonecrosis of a vertebral body(Kummell's disease).Acta Orthop Belg.2002;68(1):13-19.
[22]张磊磊,李健.Kummell病的研究进展[J].中国矫形外科杂志,2015,23(9):816-819.
[23]van der Schaaf I,Fransen H.Percutaneous vertebroplasty as treatment for Kummell's disease.JBR-BTR.2009;92(2):83-85.
[24]Marie PJ,Kassem M.Osteoblasts in osteoporosis:past,emerging,and future anabolic targets.Eur J Endocrinol.2011;165(1):1-10.
[25]Matzaroglou C,Georgiou CS,Assimakopoulos K,et al.Kummell's disease:pathophysiology,diagnosis,treatment and the role of nuclear medicine.Rationale according to our experience.Hell J Nucl Med.2011;14(3):291-299.
[26]Wu AM,Chi YL,Ni WF.Vertebral compression fracture with intravertebral vacuum cleft sign:pathogenesis,image,and surgical intervention.Asian Spine J.2013;7(2):148-155.
[27]He D,Yu W,Chen Z,et al.Pathogenesis of the intravertebral vacuum of Kummell's disease.Exp Ther Med.2016;12(2):879-882.
[28]Laredo JD.Expert's comment concerning Grand Rounds case entitled"Kümmell's disease:delayed post-traumatic osteonecrosis of the vertebral body"(by R.Ma,R.Chow,F.H.Shen).Eur Spine J.2010;19(7):1071-1072.
[29]Matzaroglou C,Georgiou CS,Assimakopoulos K,et al.Kummell's disease:A rare spine entity in a young adult.Hell J Nucl Med.2010;13(1):52-55.
[30]Baba H,Maezawa Y,Kamitani K,et al.Osteoporotic vertebral collapse with late neurological complications.Paraplegia.1995;33(5):281-289.
[31]Wang Q,Wang C,Fan S,et al.Pathomechanism of intravertebral clefts in osteoporotic compression fractures of the spine:basivertebral foramen collapse might cause intravertebral avascular necrosis.Spine J.2014;14(6):1090-1091.
[32]Wang H,Sribastav SS,Ye F,et al.Comparison of Percutaneous Vertebroplasty and Balloon Kyphoplasty for the Treatment of Single Level Vertebral Compression Fractures:A Meta-analysis of the Literature.Pain Physician.2015;18(3):209-222.
[33]Zhang H,Xu C,Zhang T,et al.Does Percutaneous Vertebroplasty or Balloon Kyphoplasty for Osteoporotic Vertebral Compression Fractures Increase the Incidence of New Vertebral Fractures?AMeta-Analysis.Pain Physician.2017;20(1):E13-E28.
[34]杨惠林.科学认识椎体成形术与椎体后凸成形术的临床价值[J].中国脊柱脊髓杂志,2010,20(6):441-443.
[35]Mc Connell CT Jr,Wippold FJ 2nd,Ray CE Jr,et al.ACRappropriateness criteria management of vertebral compress fratures.JAm Coll Radiol.2014;11(8):757-763.
[36]Kim YC,Kim YH,Ha KY.Pathomechanism of intravertebral clefts in osteoporotic compression fractures of the spine.Spine J.2014;14(4):659-666.
[37]Ren H,Wang J,Chen J,et al.Clinical efficacy of unipedicular versus bipedicular percutaneous vertebroplasty for Kummell's disease.JSouth Med Univ.2014;34(9):1370-1374.
[38]Venmans A,Klazen CA,van Rooij WJ,et al.Postprocedural CT for perivertebral cement leakage in percutaneous vertebroplasty is not necessary--results from VERTOS II.Neuroradiology.2011;53(1):19-22.
[39]Saracen A,Kotwica Z.Complications of percutaneous vertebroplasty:An analysis of 1100 procedures performed in 616 patients.Medicine.2016;95(24):e3850.
[40]Yang H,Gan M,Zou J,et al.Kyphoplasty for the treatment of Kümmell's disease.Orthopedics.2010;33(7):479.
[41]Ha KY,Lee JS,Kim KW,et al.Percutaneous vertebroplasty for vertebral compression fractures with and without intravertebral clefts.J Bone Joint Surg Br.2006;88:629-633.
[42]Kong LD,Wang P,Wang LF,et al.Comparison of vertebroplasty and kyphoplasty in the treatment of osteoporoticvertebral compression fractures with intravertebral clefts.Eur J Orthop Surg Traumatol.2014;24(Suppl 1):S201-208.
[43]Tanigawa N,Kariya S,Komemushi A,et al.Cement leakage in percutaneous vertebroplasty for osteoporotic compression fractures with or without intravertebral clefts.AJR Am J Roentgenol.2009;193:W442-445.
[44]Komemushi A,Tanigawa N,Kariya S,et al.Percutaneous vertebroplasty for osteoporotic compression fracture:multivariate study of predictors of new vertebral body fracture.Cardiovasc Intervent Radiol.2006;29:580-585.
[45]Kim YJ,Lee JW,Park KW,et al.Pulmonary cement embolism after percutaneous vertebroplasty in osteoporotic vertebral compression fractures:incidence,characteristics,and risk factors.Radiology.2009;251:250-259.
[46]Ren H,Shen Y,Zhang YZ,et al.Correlative factor analysis on the complications resulting from cement leakage after percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture.J Spinal Disord Tech.2010;23:e9-15.
[47]Chen L,Dong R,Gu Y,et al.Comparison between Balloon Kyphoplasty and Short Segmental Fixation Combined with Vertebroplasty in the Treatment of Kümmell's Disease.Pain Physician.2015;18(4):373-381.
[48]Zhang ZF,Yang JL,Jiang HC,et al.An updated comparison of high-and low-viscosity cement vertebroplasty in the treatment of osteoporotic thoracolumbar vertebral compression fractures:A retrospective cohort study.Int J Surg.2017;43:126-130.
[49]Wu AM,Li XL,Li XB,et al.The outcomes of percutaneous kyphoplasty in treatment of the secondary osteoporotic vertebral compression factures:a case-control study.Ann Transl Med.2018;6(6):107.