Nghiên cứu đặc điểm lâm sàng và cận lâm sàng của tổn thương xẹp thân đốt sống lành tính do loãng xương

Abstract

Objective: To describe the clinical and paraclinical characteristics of benign vertebral body collapse due to osteoporois at Friendship Hospital. Subject and method: Prospective research was conducted, describing longitudinal follow-up analysis on 150 patients diagnosed with benign vertebral body collapse due to osteoporois at Friendship Hospital from January 2017 until April 2024. Result: 150 patients in the study group: Females accounted for the majority at 57.3%. The average age of the research group was 78.4 ± 8.9 years old, with the largest age group being over 80 years old at 46.7%. Four patients (2.7%) used corticosteroids, and five patients (3.4%) had chronic nephritis, including one patient with grade V chronic kidney failure (0.7%). Sixteen patients (10.7%) had collapse of the old vertebral body; however, only nine patients (6.0%) received percutaneous vertebroplasty. The majority of patients were hospitalized due to spinal pain, accounting for 97.3% of cases. The second most common symptom was paravertebral muscle contraction, with a rate of 31.3%. Among 196 collapsed vertebral bodies on X-ray, vertebral bodies T12, L1, L2 accounted for the highest rate, respectively, T12 collapsed at a rate of 24.5%; L1 collapse accounts for 31.6% and L2 vertebral body collapse accounts for 18.9%. There was no damage observed from the T4 body or above. The Cobb angle of the vertebra showed the most significant change, with the largest angle of 38.9°, the largest kyphosis angle of the vertebra being 32.4°, and the largest collapse angle being 22.1°. The height of the back wall was less variable than the front and middle walls. Among patients undergoing magnetic resonance imaging, 182 vertebral bodies showed bone marrow edema, with type 1 bone marrow edema accounting for the highest rate at 54.2%. The highest proportion of patients with bone marrow edema in one vertebral body was 73.5%. Conclusion: Benign vertebral body collapse due to osteoporois occurs mainly in the elderly and has a predominance in women. Common risk factors include patients using corticosteroids and smoking. Characteristics observed on X-ray and magnetic resonance imaging aid in diagnosing the injury as well as predicting treatment.