椎体强化术治疗胸腰段骨质疏松性椎体骨折后影响骨折椎体复位的相关因素分析  

Risk factors of vertebra restoration after percutaneous vertebral augmentation in the treatment of osteoporotic vertebra compression fractures

作　　者：于淼[1] 肖隆艺[1] 曹正霖[1] 郭丹青[2] YU Miao;XIAO Longyi;CAO Zhenglin;GUO Danqing(Spine Department,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China;Spine Department,the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine)

机构地区：[1]佛山市中医院脊柱科,广东佛山528000 [2]广州中医药大学第一附属医院脊柱科

出　　处：《包头医学院学报》2018年第9期10-12,19,共4页Journal of Baotou Medical College

基　　金：佛山市医学类科技攻关项目(2015AB00352)

摘　　要：目的:研究椎体强化术治疗骨质疏松性椎体压缩骨折(OVCFs)影响骨折椎复位的相关因素。方法:回顾性纳入自2015年5月至2017年12月收治的初次采用经皮椎体成形术(PVP)或经皮后凸成形术(PKP)治疗的OVCFs患者118例,根据术后骨折椎体复位情况将患者分为两组,术后椎体高度>原始椎体高度60%的为复位组,术后椎体高度<原始高度60%的为未复位组,对两组患者数据进行相关因素分析。结果:多因素回归分析提示嵌插型骨折(OR=4. 22,P=0. 04)、骨密度(OR=1. 95,P=0. 01)、病程(OR=1. 11,P=0. 04)是术后骨折复位的预测因素,骨折部位、是否使用球囊及实际注射骨水泥量对骨折椎体复位无影响(P> 0. 05)。结论:嵌插型骨折、更高的骨密度以及更短病程的患者,接受椎体强化术后椎体高度的改善可能更好。Objective： To investigate the risk factors of vertebra restoration after percutaneous vertebral augmentation（ PVA） in the treatment of osteoporotic vertebra compression fractures（ OVCFs）. Methods： 118 patients with OVCFs initially treated with percutaneous vertebroplasty（ PVP） or percutaneous kyphoplasty（ PKP） from May 2015 to December 2017 were enrolled and separated into 2 groups： 1） reduced group： the height of augmented vertebra was more than 60 % of the original height; and 2） not-reduced group： the height of augmented vertebra was less than 60 % of the original height. The relative factors were analyzed in the two groups. Results： The multivariate regression analysis indicated that compacted fractures（ OR = 4. 22,P = 0. 04）,bone mineral density（ BMD）（ OR = 1. 95,P =0. 01） and disease duration（ OR = 1. 11,P = 0. 04） were the predicting factors for restored vertebra height after PVA. The fracture location,balloon use and volume of injected bone cement were not relative to height restoration of the augmented vertebra after PVA（ P 〉 0. 05）. Conclusions： Patients with compacted fracture,higher BMD and shorter disease duration may acquire better height restoration of the augmented vertebra after PVA.

关 键 词：椎体强化术 椎体复位 椎体后凸成形术 相关因素分析 骨质疏松性椎体压缩骨折 

分 类 号：R687.3[医药卫生—骨科学]