经皮椎体强化术后椎体再发骨折的研究进展

Research advances of vertebral refractures after percutaneous vertebroplasty

摘要

该文系统回顾了皮椎体强化术（PVA）术后椎体再发骨折的研究进展。PVA术后椎体再发骨折的发生机制复杂，涉及患者自身因素（如骨质疏松、年龄、性别、体质量指数等）和手术相关因素（如骨水泥类型、灌注率、分布、渗漏及手术椎体数量等）。预防与治疗方面，抗骨质疏松治疗是关键，多种药物显著提升了患者骨密度，降低了椎体骨折风险；手术技术改进（如骨填充网袋椎体成形术、未填充区域二次穿刺、明胶海绵预填充等）及术后康复锻炼也有效降低了椎体再发骨折率。未来研究应聚焦多因素综合干预，研发更优骨水泥材料，探索新技术，加强长期随访，构建“精准预防-技术创新-系统管理”三位一体策略，以降低再发骨折风险，改善患者生活质量。

Abstract

This article systematically reviews the research progress on vertebral refracture after percutaneous vertebral augmentation (PVA). The pathogenesis of vertebral refracture after PVA is complex, involving both patient related factors (such as osteoporosis, age, gender, BMI, etc.) and surgery related factors (such as bone cement type, injection rate, distribution, leakage, and the number of surgical vertebrae, etc.). In terms of prevention and treatment, antiosteoporosis therapy is crucial. Various medications have significantly increased patients' bone mineral density and reduced the risk of vertebral fractures. Improvements in surgical techniques and postoperative rehabilitation exercises have also effectively reduced the rate of vertebral refracture. Future research directions should focus on comprehensive interventions of multiple factors, developing bone cement materials with mechanical properties closer to human bone tissue, optimizing surgical techniques, strengthening long term follow up, and constructing a "precision prevention-technology innovation-systematic management" integrated strategy to further reduce the risk of refracture and improve patients' quality of life.

关键词

骨质疏松性椎体压缩骨折 / 经皮椎体强化术 / 经皮椎体成形术 / 经皮球囊扩张椎体后凸成形术 / 再发骨折

Key words

Osteoporotic Vertebral Compression Fractures / Percutaneous Vertebral Augmentation / Percutaneous Vertebroplasty / Percutaneous Kyphoplasty / Refracture

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基金资助

大学生创新创业训练计划项目(S202510488178)