胸腰段椎体骨折经后路手术术后骨缺损形成情况及危险因素分析  

Analysis of the formation and risk factors of bone defects after posterior surgery for thoracolumbar vertebral fractures

作　　者：张伟[1] 杨金华[1] 黄开[1] 潘文明[1] ZHANG Wei;YANG Jin-hua;HUANG Kai;PAN Wen-ming(Department of Orthopedics,the Second People＇s Hospital of Changshou,Suzhou,Jiangsu,215500,China.)

机构地区：[1]江苏省苏州市常熟市第二人民医院骨科,江苏苏州215500

出　　处：《颈腰痛杂志》2018年第6期731-734,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨胸腰段椎体骨折经后路手术术后骨缺损形成情况,并进行相关危险因素分析。方法纳入2014-06-2017-06行后路切开复位椎弓根钉棒系统复位内固定术治疗的297例胸腰椎骨折患者,随访12个月以上,观察术后骨缺损形成情况。将骨缺损患者设为缺损组,其余设为未缺损组。调查两组患者性别、年龄、骨折情况等病历资料,对术后骨缺损形成的相关因素进行分析,组间单因素分析具有统计学意义的项目再行多因素Logistic回归分析。结果 297例患者术后骨缺损形成30例,骨缺损率10.10%。两组骨密度T值、伤椎前缘高度缺失程度、年龄、植骨情况、骨折类型、术前Cobb角、伤椎置钉情况、身体质量指数(BMI)差异有统计学意义(P<0.05);多因素Logistic回归分析显示,骨密度T值、伤椎前缘高度缺失程度、年龄、植骨情况,均是独立危险因素。结论胸腰段椎体骨折经后路手术后,容易出现骨缺损;骨密度T值、伤椎前缘高度缺失程度、年龄、植骨情况,均是骨缺损形成的影响因素。Objective To analyze the formation and risk factors of bone defects after posteriorsurgery for thoracolumbar vertebral fractures. Methods A total of 297 patients with thoracolumbarfractures who accepted posterior pedicle screw system reduction and internal fixation treatment in ourhospital from June 2014 to June 2017 were selected in this study. All patients accepted posterior openreduction and internal fixation treatment. The patients were followed up for more than 12 months. Theformation situation of bone defects was observed. The patients with bone defects were set as the defectgroup, and the rest patients were set as the defect-free group. Medical records such as gender, age andfracture status of the two groups were investigated. Items with statistically significant differencesbetween two groups through univariate analysis carried on multivariate Logistic regression analysis todetermine the independent risk factors for the formation of bone defects after posterior surgery forthoracolumbar vertebral fractures. Results There were 30 cases of postoperative bone defect formationin 297 patients, and the bone defect rate was 10.10%. The differences of bone mineral density T value,height of the injured vertebrae leading edge, age, bone grafting, fracture type, preoperative Cobb angle,injury screw placement, and body mass index （BMI） were statistically significant（P〈0.05）. MultivariateLogistic regression analysis showed that bone density T value, degree of height loss in the front of theinjured vertebra, age, bone grafting situation were independent risk factors for the formation of bonedefects after posterior surgery for thoracolumbar vertebral fractures. Conclusion Thoracolumbarvertebral fractures are prone to bone defects after posterior surgery. T-value of bone density, degree ofheight loss of the front of the injured vertebrae, age and bone grafting situation are influencing factorsof bone defect formation.

关 键 词：胸腰段椎体骨折 后路手术 骨缺损形 危险因素 

分 类 号：R687.3[医药卫生—骨科学] R683.2[医药卫生—外科学]