经皮椎体成形术后相邻椎体再骨折的相关因素  

Associated factors for subsequent adjacent vertebral body refracture after percutaneous vertebro- plasty

作　　者：余鹏[1] 夏群[2] 皮红林 金鸿宾[2] 吴群海 

机构地区：[1]天津中医药大学研究生院,天津300193 [2]天津医院骨科,天津300193 [3]襄阳市中医院脊柱骨科

出　　处：《中华创伤杂志》2013年第11期1063-1067,共5页Chinese Journal of Trauma

摘　　要：目的探讨经皮椎体成形术（percutaneous vertebroplasty，PVP）治疗骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fractures，OVCFs）患者后相邻椎体再骨折的影响因素。方法回顾性分析2007年7月一2010年3月收治的OVCFs而施行单椎体PVP治疗的患者，记录患者年龄、性别、骨密度、骨水泥注入剂量、骨水泥渗漏及手术前后椎体复位情况。应用Kaplan—Meier存留率曲线预测再骨折发生的时间趋势；分析PVP后导致相邻椎体再骨折的相关因素。结果共纳入216例患者，其中男98例，女118例；年龄55～76岁，平均65．4岁。术后随访12～18个月。92例发生再骨折，其中68例发生在相邻椎体；相邻椎体再骨折发生率有相对明显的时间集中趋势，66％（45／68）发生在100d内，此后再骨折发生率显著降低；非相邻椎体的再骨折发生率无显著的时间集中趋势。骨水泥注入剂量、椎体复位情况与相邻椎体再骨折的发生率有显著相关性；年龄、性别、骨密度、骨水泥渗漏与否与术后相邻椎体骨折无显著相关性。结论对OVCFs患者实施PVP更易导致相邻椎体再骨折，其影响因素可能与骨水泥注入剂量、椎体复位情况等相关。Objective To investigate the influential factors for refracture of the adjacent vertebral body following percutaneous vertebroplasty （PVP） treatment of patients with osteoporotic vertebral com- pression fractures （OVCFs）. Methods A retrospective analysis was conducted on OVCFs patients un- dergone mono-segmental PVP from July 2007 to March 2010. Patients＇ age, gender, bone density, bone cement infusion dosage, bone cement leakage and pre-and post-operative fracture reduction were docu- mented. Kaplan-Meier remaining rate curve was used to predict the trend of time to refracture. The relat- ed factors for adjacent vertebral body refracture following PVP were analyzed. Results In all, 216 pa- tients （98 males and 118 females; age range of 55-76 years, average 65.4 years） were enrolled in this study. Follow-up lasted for 12-18 months. Ninety-two patients sustained refracture including 68 patients with refracture of the adjacent vertebral body. Refracture of the adjacent vertebral body presented time- concentrated tendency and 66% （45/68） occurred within 100 days followed by a notably lower inci- dence. Whereas the time to refracture of the non-adjacent vertebral body was not obviously centralized. Bone cement infusion dosage and vertebral body reset condition were strongly associated with the refracture incidence of the adjacent vertebral body, while opposite results were observed in regard of age, gender, bone density and bone cement leakage （or not）. Conclusion PVP predisposes OVCFs patients to re- fracture of the adjacent vertebral body and its influential factors may be associated with bone cement infu- sion dosage and vertebral body reduction condition.

关 键 词：脊柱损伤 胸椎 腰椎 骨质疏松 经皮椎体成形术 

分 类 号：R687.3[医药卫生—骨科学]