PVP术后相邻椎体新发骨折的危险因素分析  

Analysis of risk factors of new adjacent vertebral fractures after PVP

作　　者：李业成[1] 张巍[2] 张成亮[1] 王洪俊[1] 刘守正[1] 朱宝林[1] 陈跃跃[1] 吴新铖 

机构地区：[1]沭阳县人民医院骨科,江苏宿迁223600 [2]沭阳县人民医院检验科,江苏宿迁223600

出　　处：《中国骨与关节损伤杂志》2017年第1期25-27,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折术后相邻椎体新发骨折的危险因素。方法纳入自2011-08—2014-08诊治的110例骨质疏松性椎体压缩骨折,按照首次PVP术后是否再次发生相邻椎体骨折将患者分为2组,其中观察组25例(术后出现相邻椎体新发骨折),对照组85例。确定年龄、体重指数、骨密度、骨水泥注入量、术后椎体高度矫正百分比、有无骨水泥椎间盘内渗漏、术前有无椎体内裂隙征、术后椎体前缘压缩角度矫正度数、后凸角度矫正度数这9个指标为PVP术后相邻椎体再骨折的相关因素。结果 110例获得随访2~3年,平均2.5年。110例中术后相邻椎体新发骨折25例,发生率为22.7%。单因素分析结果显示,观察组与对照组骨密度、骨水泥椎间盘内渗漏、术前椎体内裂隙征方面差异有统计学意义(P<0.05)。进一步多因素Logistic回归分析显示低骨密度是PVP术后相邻椎体新发骨折的独立危险因素。结论 PVP术后相邻椎体新发骨折的危险因素是骨质疏松,因此PVP术后应该正规抗骨质疏松治疗,防止继发骨折的出现。Objective To evaluate the risk factors associated with new adjacent vertebral fractures after pereutaneous vertebroplasty （PVP） to treat osteoporotic vertebral compression fractures. Methods Between August 2011 and August 2014, 110 cases of osteoporotic vertebral compression fractures were treated with PVP. According to the follow-up results, the patients were divided into the observed group of 25 patients with postoperative new adjacent vertebral fractures while the control group of 85 cases by onset of a new fracture. Possible risk factors, such as age, body mass index, bone mineral density （BMD）, amount of bone cement injected, percentage of height restoration of the vertebral, intradiscal cement leak, vacuum clefts in the collapsed bodies, change of the wedge angle and Kyphotic angle after vertebroplasty and were assessed. Results All of ll0 patients were reviewed, with a mean fallow-up of 2.5 years （range 2-3 years）. Twenty-five patients （22.7%） after PVP sustained symptomatic new adjacent vertebral fractures. Significant differences were found between the observed group and the control group in regard to BMD, vacuum clefts in the collapsed bodies and the proportion of cement leakage into the disc space （P 〈0.05）. Logistic analysis showed that several risk factor associated with non-surgical vertebral fracture was the osteoporosis. Conclusion The incidence of new adjacent vertebral compression fractures after PVP is relatively high and affected by several risk factors related to the natural course of osteoporosis.

关 键 词：骨质疏松性椎体压缩骨折 经皮椎体成形术 相邻椎体 新发骨折 危险因素 

分 类 号：R687.3[医药卫生—骨科学]