骨质疏松椎体骨折成形术后新骨折发生的分析研究  

Analysis for new fracture of vertebral body after percutaneous vertebroplasty in patients with osteoporosis

作　　者：林华[1] 包丽华[2] 朱秀芬[1] 陈新[1] 张咏梅[1] 韩祖斌[1] 

机构地区：[1]南京大学医学院附属鼓楼医院骨病中心,南京210008 [2]江苏省人民医院核医学科,南京210029

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2008年第1期19-23,共5页Chinese Journal Of Osteoporosis And Bone Mineral Research

基　　金：南京市医学科技重点发展基金（ZKG9913）

摘　　要：目的探讨骨质疏松椎体骨折经皮椎体成形术后新骨折发生的影响因素。方法29名胸腰椎脆性骨折经皮单椎体成形术的绝经后妇女被分成两组，14名伴术后椎体新骨折发生者为新骨折组，另15名术后未有新骨折发生者为对照组。分析内容包括：年龄，体质指数，骨折史，代谢性疾病及其治疗史，抗骨质疏松治疗，腰背支具使用，腰椎和髋部骨密度，甲状旁腺激素和血钙磷水平，椎体成形术后时间等。结果新骨折组与对照组比较，下列项目有统计学差异，体质指数显著降低（P=0．027），腰椎骨密度显著下降（P=0．015），髋部骨密度显著下降（P=0．037），甲状旁腺激素水平明显升高（P=0．017）。骨折史，代谢性疾病及其治疗史，抗骨质疏松治疗，腰背支具使用亦影响新骨折的发生。另外，新骨折组14例中有12例（86％）的新骨折发生在椎体成形术后的6个月内，14例中有10例（71％）为邻近椎体成形术椎体骨折。结论骨质疏松椎体骨折经皮椎体成形术后新骨折发生有三分之二发生在成形术的邻近椎体，新骨折发生受到体质指数，骨折史，代谢性疾病及其治疗史，抗骨质疏松治疗，腰背支具使用，腰椎和髋部骨密度等因素影响。Objective To investigate the affecting factors of new fracture of vertebral body after percutaneous vertebroplasty in patients with osteoporosis. Methods 29 postmenopausal osteoporosis patients who had received only one vertebroplasty for a single level of vertebral compression fracture were divided into two groups, there were 14 patients who had recurrent fracture of new vertebral body after precutaneous vertebroplasty in new fracture group, 15 patients who had not recurrent fracture of new vertebral body after precutaneous vertebroplasty were in control group. The following parameters were reviewed： age, BMI, history of fractures, history of metabolic diseases, anti-osteoporosis therapy, bracket of back using, lumbar spine and hip bone mineral density, iPTH, serum calcium and serum phosphorus, period after treatment with vertebroplasty. Results Compared with control group, patients in new fracture group had statistically signifi- cantly difference, which included BMI （P =0. 027）, lumbar spine bone mineral density （P =0. 015）, hip bone mineral density （ P = 0. 037） and iPTH level （P = 0. 017）. History of fractures, metabolic diseases and medications, anti-osteoporosis therapy, bracket of back using were important associated factors of recurrent fracture of new vertebral body after percutaneous vertebroplasty in patients with osteoporosis. In addition, 12 （86%） of the 14 new vertebral fractures occurred within 180 days after treatment of the initial fracture, and 10 （71%） of the 14 patients had adjacent fractures to those previously treated with percutaneous vertebroplasty. Conclusion A substantial number of patients with osteoporosis developed new fractures after undergoing percutaneous vertebroplasty, two-thirds of these new fractures occurred in verte-brae adjacent to those previously treated. The following parameters were influence factors ： BMI, history of fractures, history of metabolic diseases and medications, anti-osteoporosis therapy, bracket of back using, lumbar spine and h

关 键 词：经皮椎体成形术 新骨折 骨质疏松椎体骨折 

分 类 号：R683.2[医药卫生—骨科学] R972.6[医药卫生—外科学]