PKP治疗骨质疏松性胸腰椎压缩骨折术后非手术椎体发生骨折的危险因素研究  

Analysis on risk factors of non-surgical vertebral fracture after percutaneous kyphoplasty for osteoporotic thoracolumbar vertebral compression fracture

作　　者：徐沁[1] 田守进[1] 倪善军[1] 周志平[1] 

机构地区：[1]江苏省张家港市第一人民医院骨科,215600

出　　处：《中国骨与关节损伤杂志》2014年第3期218-220,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨骨质疏松性胸腰椎压缩骨折经皮椎体后凸成形术(PKP)后非手术椎体新发骨折的危险因素。方法收集自2010-01—2012-06诊断为骨质疏松性胸腰椎压缩骨折60例的资料,根据随访结果按是否有非手术椎体新发骨折可分为新发骨折组(23例)及未骨折组(37例)。结果单因素分析结果显示术前骨密度、骨折椎体数、骨折压缩率、椎体高度恢复率、手术强化椎体数、骨水泥渗漏率及长期糖皮质激素使用史方面差异有统计学意义(P<0.05);多因素Logistic回归分析显示术前骨折椎体数多、手术强化椎体数目多、骨质疏松程度重及长期糖皮质激素使用史是PKP术后非手术椎体新发骨折的危险因素(P<0.05)。结论术前骨折椎体数多、手术强化椎体数目多、骨质疏松程度重及长期糖皮质激素史是引起骨质疏松性胸腰椎压缩骨折PKP术后非手术椎体新发骨折的危险因素,应当引起临床医生的重视。Objective To explore the risk factors of non-surgical vertebral fracture secondary to percutaneous kyphoplasty （PKP） for osteoporotic thoracolumbar vertebral compression fracture. Methods The clinical material and follow-up results of 60 patients who received PKP due to osteoporotic thoracolumbar vertebral compression fracture between January 2010 and June 2012 were retrospectively analyzed. Based on the follow-up results, the patients were divided into refracture group（23 cases） and non-refracture group （control group, 37 cases） according to the onset of a new fracture. Results Univariate analysis indicated that bone mineral density, number of preoperative fractured vertebrae, fracture compression rate, the recovery rate of vertebral body height, number of bone cement augmented vertebrae, bone cement leakage and history of long-term use of glucocorticoids were statistically different between two groups （P 〈0.05）. Logistic regression analysis showed that more preoperative fractured vertebrae, more augmented vertebrae, severe degree of osteoporosis and long-term use of glueocortieoids were high risk factors for non-surgical vertebrae fracture （P 〈0.05）. Conclusion Multiple preoperative fractured and augmented vertebrae, severe osteoporosis and long-term use of glueocorticoids are high risk factors for non- surgical vertebrae fracture, which surgeons should pay more attention to.

关 键 词：经皮椎体后凸成形术 骨质疏松 胸腰椎压缩骨折 非手术椎体 新发骨折 

分 类 号：R687.3[医药卫生—骨科学]