骨质疏松性胸腰椎体压缩骨折发病位置与骨质密度对患者下腰疼痛影响的研究  

Study of osteoporotic thoracolumbar vertebral compression fracture incidence position and influence on bone mineral density in patients with low back pain

作　　者：张生[1] 杨明智[1] 祁学强 

机构地区：[1]延安市人民医院骨科一病区,陕西延安716000

出　　处：《临床和实验医学杂志》2017年第17期1752-1755,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探究骨质疏松性胸腰椎体压缩骨折发病位置与骨质密度对患者下腰疼痛影响。方法选取2014年月10至2016年10月期间收治的112例行椎体后凸成形术的骨质疏松性胸腰椎体压缩骨折患者,根据患者年龄的不同将患者分成Ⅰ(年龄60~70岁)、Ⅱ(年龄71~80岁)、Ⅲ组(年龄81~90岁)。常规进行经皮椎体后凸成形术及X线片检查;观察比较患者年龄、性别构成比、骨折发病位置,骨质密度及术后下腰部疼痛的发生率等数据。结果随着患者年龄的增加,患者的骨密度数值、T值逐渐下降,各组比较差异具有统计学意义(P<0.05);112例患者中,术后下腰部疼痛的发病率为14.29%;Ⅰ组患者的发病位置为T_(11),T_(12);Ⅱ组患者的发病位置为T_(12_,T_1;Ⅲ组患者的发病位置为L_2,L_3。随着患者发病位置逐渐靠近下腰椎,患者的下腰部疼痛的发病率及VAS不断升高,两者呈正相关(r=0.273,P=0.018);随着患者VAS评分的不断增加,患者的骨密度、T值(SD)随之下降,术后下腰部疼痛程度与腰椎骨密度呈负相关关系(r=-0.267,P=0.016)。结论随着患者发病位置逐渐靠近下腰椎,患者的下腰部疼痛的发病率及疼痛程度不断增加,两者呈正相关;术后下腰部疼痛程度与腰椎骨密度呈负相关。Objective To study the treatment of osteoporotic thoracolumbar vertebral compression fracture incidence and influence of body position on bone mineral density in patients with low back pain. Methods 112 cases of osteoporetic vertebral body undergoing kyphoplasty compres- sion fractures were selected from the October 2014 to October 2016. According to the different age of patients, the patients were divided into I, II, III group. All these patients received routine percutaneous kyphoplasty and X examination. The age, sex, location of fracture, bone mineral density and the incidence of lower lumbar pain were observed and compared. Results Patients with the increasing of age, bone mineral density, T numerical values were decreased, the differences were significant （ P 〈 0.05 ）. In 112 patients, the incidence of postoperative low back pain rate was 14.29%. The location of disease in Ⅰ group were T11 , T12. The location of the patients in the Ⅱ group of T12, T1. The location of disease in Ⅲ group were L2, L3. With the location of disease was gradually close to the lower lumbar spine, and the incidence of VAS in patients with low back pain is increasing. There is a positive correlation between them （ r = 0. 273, P = 0. 018 ）. With the increase of patients VAS score, bone mineral density, with T value （SD） decreased, postoperative back pain and lumbar bone mineral density was negatively correlated （ r = -0. 267, P =0. 016）. Conclusion With the location of disease patients gradually close to the lower lumbar spine, the incidence rate and pain degree of patients with low back pain in- creased, there was a positive correlation between them; the postoperative back pain and lumbar bone density was negatively correlated.

关 键 词：骨质疏松 胸腰椎体压缩骨折 骨质密度 下腰疼痛 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学]